David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Ezio Di Nucci
Jack Alan Reynolds
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Bioethics 26 (2):108-116 (2012)
There is an important gap in philosophical, clinical and bioethical conceptions of decision-making capacity. These fields recognize that when traumatic life circumstances occur, people not only feel afraid and demoralized, but may develop catastrophic thinking and other beliefs that can lead to poor judgment. Yet there has been no articulation of the ways in which such beliefs may actually derail decision-making capacity. In particular, certain emotionally grounded beliefs are systematically unresponsive to evidence, and this can block the ability to deliberate about alternatives. People who meet medico-legal criteria for decision-making capacity can react to health and personal crises with such capacity-derailing reactions. One aspect of this is that a person who is otherwise cognitively intact may be unable to appreciate her own future quality of life while in this complex state of mind. This raises troubling ethical challenges. We cannot rely on the current standard assessment of cognition to determine decisional rights in medical and other settings. We need to understand better how emotionally grounded beliefs interfere with decision-making capacity, in order to identify when caregivers have an obligation to intervene
|Keywords||competence fear emotion psychiatric assessment health decisions decision‐making capacity autonomy|
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Citations of this work BETA
Gerben Meynen (2011). Depression, Possibilities, and Competence: A Phenomenological Perspective. [REVIEW] Theoretical Medicine and Bioethics 32 (3):181-193.
Katherine Carroll & Catherine Waldby (2012). Informed Consent and Fresh Egg Donation for Stem Cell Research. Journal of Bioethical Inquiry 9 (1):29-39.
Helena Hermann, Manuel Trachsel & Nikola Biller-Andorno (forthcoming). Einwilligungsfähigkeit: Inhärente Fähigkeit Oder Ethisches Urteil?Decision-Making Capacity: Inherent Ability or Ethical Judgment? Ethik in der Medizin.
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