Proxy Consent and Counterfactuals

Yujin Nagasawa

Research output: Contribution to journalArticle

6 Citations (Scopus)


When patients are in vegetative states and their lives are maintained by medical devices, their surrogates might offer proxy consents on their behalf in order to terminate the use of the devices. The so-called 'substituted judgment thesis' has been adopted by the courts regularly in order to determine the validity of such proxy consents. The thesis purports to evaluate proxy consents by appealing to putative counterfactual truths about what the patients would choose, were they to be competent. The aim of this paper is to reveal a significant limitation of the thesis, which has hitherto been recognised only vaguely and intuitively. By appealing to the metaphysics of counterfactuals I explain how the thesis fails to determine the validity of proxy consents in a number of actual cases.
Original languageEnglish
Pages (from-to)16-24
Number of pages9
Early online date25 Oct 2007
Publication statusPublished - 25 Oct 2007


  • counterfactuals
  • substituted judgment
  • proxy consent
  • vegetative states
  • euthanasia


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