Rebecca Dresser and John Robertson make this criticism of what they call “the orthodox approach” to ADs prevalent in American law courts and dominant in the outlook of many others.5 In the orthodox approach, “respect for incompetent patients requires according such patients the same right to refuse treatment accorded competent patients.” Refusal is based on the patient’s own wishes, either stated in an AD or discerned by the patient’s proxy in “substituted judgment” about those wishes. Allegedly this respects the autonomy of the person in avoiding treatment the patient does not want.
