  The Substituted Judgment standard seems well-suited to the circumstances of the formerly competent patients since, in their case, there are past values or patterns of decision-making that could potentially serve as a basis for the reconstructed decision on the patient's behalf. Furthermore, according to the current orthodoxy, prevalent especially in the law, Substituted Judgment is the preferred solution for formerly competent patients because it promises to preserve respect for  autonomy  as an overriding moral consideration trumping concerns with  beneficence. The picture is this. If, ordinarily, we ought to respect patient autonomy rather than impose our own judgments on patients, we ought to respect autonomy even after the patient has lost decision-making capacity; and we can do so by following or reconstructing, as best we can, the autonomous decision the patient would have made himself when faced with the current circumstances. In short, in dealing with someone who used to be competent, the widely accepted primacy of respect for autonomy over beneficence calls for Substituted Judgment. And this means that we should use the Substituted Judgment standard whenever possible and fall back on the Best Interests standard only when we lack sufficient information about the patient's prior wishes and values to make Substituted Judgment practicable.