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     "Norman Cantor tackles the most vexing problem of health care decision making: how to make decisions for people who cannot make them for themselves. At first glance, this issue would seem to be of interest only to bioethicists and physicians. But as the decline of mental faculties concurrent with aging, serious illness, or both is something that no one can count on avoiding, this should be a matter of concern to all. After decades of wandering in the woods, there is finally an overarching approach to this problem in Cantor`s work." - Alan Meisel, Professor of Law, and Dickie, McCamey & Chilcote Professor of Bioethics, University of Pittsburgh....
    

 "Autonomy rules American bioethics, but as Norman Cantor demonstrates in this wonderfully lucid and compelling book, it is human dignity that ultimately marks the obligations of medical decision makers for the profoundly mentally impaired patient. Cantor's careful scholarship will be of tremendous help to U.S. courts (and care providers) in their ongoing effort to apply the 'best interests of the patient' standard in the context of medical care, end-of-life decisions, organ donation, and human experimentation." -  George J. Annas, Boston University School of Public Health, author of
American Bioethics: Crossing Human Rights and Health Law Boundaries
     "Norman Cantor has long been one of the leading contributors to the literature on legal and ethical issues in end-of-life care. Making Medical Decisions for the Profoundly Mentally Disabled is the first systematic treatment of this increasingly important issue, and should contribute to improvements in medical practice and public policy." - Dan W. Brock, Frances Glessner Lee Professor of Medical Ethics, Harvard Medical School.
     "Going beyond his earlier work, Cantor has produced a provocative set of general principles for surrogate decision making drawn from an extensive and critical review of American law on the subject."  - Charles H. Baron, Boston College Law School.

vii Series Foreword
ix Acknowledgments
1 Introduction
13 1 The Moral Status of the Profoundly Disabled: Persons or Something Less?
13 The Concepts of Personhood and Full Moral Status
17 Criteria of Personhood
20 The Legal and Moral Status of the Profoundly Disabled
26 The Role of Intrinsic Human Dignity
33 2 The Profoundly Disabled as Rights Holders: No Rights, the Same
Rights as the Fully Capacitated, or Some Rights?
33 Attributing the "Same Rights" to the Profoundly Disabled
41 A Constitutional Claim to Appropriate Medical Options
43 A Constitutional Right to Some Surrogate Decision on Behalf of the
Disabled Person?
69 3 Who Decides for the Profoundly Disabled?
70 Minors Living with Their Parents
94 Disabled Persons Living in Institutions
101 4 Defining the Best Interests of Profoundly Disabled Persons
103 The Focus on a Never Competent Patient's Weil-Being
106 The Problematic of Assessing Well-Being
113 Quality of Life, Dignity, and Never Competent Persons
127 Must Medical Decisions Be in the Best Interests of a Profoundly
Disabled Person?
136 Can the Interests of Others Be Included within a Person's Best
Interests?
149 5 Forced Altruism
149 The Problematic of Surrogate Consent to Nontherapeutic Medical Handling
151 Reliance on the Best Interests of the Profoundly Disabled Patient
154 Discrimination against the Disabled
156 The Kantian Imperative
159 Existing Jurisprudence
159 The Decided Cases on the Donation of Bodily Resources
164 The Legal and Moral Frameworks Governing Nontherapeutic
Medical Research
169 Justifications for Seeking Sacrifice from Profoundly Disabled Persons
169 Utilitarianism as a Rationale for Exploitation
173 Ascribing Altruism to Never Competent Persons
178 Parental Child-Rearing Prerogatives
186 Social Fairness as a justification for Using the Profoundly Disabled
191 The Limits of a Surrogate's Imposition of Sacrifice
203 6 The Voice of the Profoundly Disabled Person
204 The Connection between Consultation and Weil-Being
206 Dignity-Based Reasons for Soliciting Input
207 Limited Self-Determination
211 Ambiguity of Expressions
215 Notes
275 References
293 Index of Cases and Statutes
295 Subject Index