Values Frameworks as Ideal Types: Navigating Ethics Conflicts with Normative Minorities

In the piece, "Surrogate Wars: The 'Best Interest Values' Hierarchy & End-of-Life Conflicts with Surrogate Decision-Makers," I argue that incommensurable value systems between healthcare providers (HCPs) and surrogate decision-makers (SDMs) lie at the root of many intractable end-of-life treatment disputes. I argue that the most prevalent value system of HCPs might be understood as a "Best Interest Values" (BIV) hierarchy and that this value system is irreconcilable with the set of "Life-Continuation Values" (LCV) held by a sizable minority of families in the United States. I believe that HCPs facing seemingly intractable conflict with SDMs would be aided by understanding their BIV values framework as just one of many cogent values systems in the context of US ethical pluralism. Five preeminent bioethicists provide insightful commentaries on my essay, offering pointed critiques, raising important challenges, and gesturing towards extensions and refinements of my argument. In this essay, I respond to those thoughtful and well-argued commentaries.