title: Familiar interests and strange analogies: Baergen and Woodhouse on extra-familial interests.
abstract: The article by Professor Baergen and Dr. Woodhouse makes a succinct and serious contribution to progress in bioethical understanding of deciding for others. They begin with what is by now a familiar claim: family proxy decision makers may sometimes make decisions on behalf of incapacitated relatives that depart from what might be optimal from the patient's point of view, since the well-being of family members, or of the family as such, may be substantially affected by the direction of a patient's care.They then develop this idea, noting that others apart from family members can also be substantially affected by a patient's treatment, and arguing that the interests of strangers ought also to sometimes have a role in determining the aims and means of a patient's treatment. Baergen and Woodhouse also devote attention to how extra-familial interests might be implemented in medical decision making. While I unearth a troubling consequence of the effort to realize their theoretical conclusion practically, my chief task is to point to some disanalogies between families and strangers, and consider the extent to which they call into question the relevance of the interests of strangers to the treatment of patients.
authors.affiliation: College of Arts and Letters at Michigan State University in East Lansing, USA. jlnelson@msu.edu
authors.forename: James Lindemann
authors.initials: JL
authors.lastname: Nelson
mesh_terms: D001932:Brain Neoplasms / Q000601:surgery*; D002650:Child Abuse, Sexual; D016265:Conflict of Interest; D003657:Decision Making / Q000941:ethics*; D005190:Family; D006801:Humans; D007326:Institutionalization; D008297:Male; D016609:Neoplasms, Second Primary / Q000601:surgery*; D012111:Residence Characteristics; D012935:Social Justice; D020458:Third-Party Consent / Q000941:ethics*