A decision made with or on behalf of a person who lacks full legal capacity to consent to or refuse medical treatment. In the case of children under the age of 16 years who are not Gillick-competent (see Gillick competence) because they are deemed insufficiently mature or understanding of their situation, people with parental responsibility will usually be asked to take a proxy decision about their care. However, parents can only consent to, or refuse, treatment on behalf of their children in so far as they are considered to be acting in the child’s best interests. For adults, a person previously nominated by the patient while he or she had capacity can be granted a lasting power of attorney and may make health-care decisions on the patient’s behalf. The decision itself may be based on either a judgment of the patient’s best interests or a judgment as to what he or she would wish in the circumstances (a substituted judgment). See also advance statement, decision, or directive; advocacy.
Subjects: Medicine and Health.