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Editor's Correspondence
March 10, 2008

Neither Freedom nor Autonomy Without Beneficence

Arch Intern Med. 2008;168(5):548-549. doi:10.1001/archinte.168.5.548-b

Varma and Wendler1 recently focused on the medical ethical challenge represented by the treatment for people lacking advanced directives or designated surrogates. They argue that it is fundamental to give them the same level of respect afforded those with surrogates. The clear identification of instruments to help physicians make treatment decisions consistent with the patient's preferences is mandatory. They propose a “population-based treatment indicator,” a computer-based tool that should be able to unravel a patient's choice by relying on the treatment preference of comparable individuals. The data to be implemented into the decisional algorithm are mainly based on “age and sex, and features of the patient's clinical situation, such as diagnosis.”1(p1712)