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Decision-making capacity

Stanford Encyclopedia of Philosophy (2011)

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  1. Do We Need a Threshold Conception of Competence?Govert den Hartogh - 2016 - Medicine, Health Care and Philosophy 19 (1):71-83.
    On the standard view we assess a person’s competence by considering her relevant abilities without reference to the actual decision she is about to make. If she is deemed to satisfy certain threshold conditions of competence, it is still an open question whether her decision could ever be overruled on account of its harmful consequences for her. In practice, however, one normally uses a variable, risk dependent conception of competence, which really means that in considering whether or not to respect (...)
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  • Subsequent Consent and Blameworthiness.Jason Chen - 2020 - HEC Forum 32 (3):239-251.
    Informed consent is normally understood as something that a patient gives prior to a medical intervention that can render it morally permissible. Whether or not it must be given prior to the intervention is debated. Some have argued that subsequent consent—that is, consent given after a medical intervention—can also render an otherwise impermissible act permissible. If so, then a patient may give her consent to an intervention that has already been performed and thereby justify a physician’s act retroactively. The purpose (...)
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  • High Court Should Not Restrict Access to Puberty Blockers for Minors.Cameron Beattie - forthcoming - Journal of Medical Ethics:medethics-2020-107055.
    Gender dysphoria is a clinically significant incongruence between expressed gender and assigned gender, with rapidly growing prevalence among children. The UK High Court recently conducted a judicial review regarding the service provision at a youth-focussed gender identity clinic in Tavistock. The high court adjudged it ‘highly unlikely’ that under-13s, and ‘doubtful’ that 14–15 years old, can be competent to consent to puberty blocker therapy for GD. They based their reasoning on the limited evidence regarding efficacy, the likelihood of progressing to (...)
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  • Psychiatric Ethics: A History.Louis C. Charland - forthcoming - In Psychiatric Ethics 5th Edition. New York, NY, USA:
    The chapter traces the history of psychiatric ethics with a focus on the emergence of autonomy and how assumptions and thresholds surrounding informed consent and decision-making capacity have changed over the centuries. Innovators like Philippe PInel and William Tuke are featured in this account of how the 'mad' and the abuses of the 'domestication paradigm' of madness eventually gave way to more humanitarian approaches of treating the 'mad', like moral treatment. The chapter closes with a brief reflection regarding the limits (...)
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  • Unreasonable Reasons: Normative Judgements in the Assessment of Mental Capacity.Natalie F. Banner - 2012 - Journal of Evaluation in Clinical Practice 18 (5):1038-1044.
  • Decision-Making Capacity.Jennifer Hawkins & Louis C. Charland - 2020 - Stanford Encyclopedia of Philosophy.
    Decision-Making Capacity First published Tue Jan 15, 2008; substantive revision Fri Aug 14, 2020 In many Western jurisdictions the law presumes that adult persons, and sometimes children that meet certain criteria, are capable of making their own medical decisions; for example, consenting to a particular medical treatment, or consenting to participate in a research trial. But what exactly does it mean to say that a subject has or lacks the requisite capacity to decide? This question has to do with what (...)
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  • From Libertarian Paternalism to Nudging—and Beyond.Adrien Barton & Till Grüne-Yanoff - 2015 - Review of Philosophy and Psychology 6 (3):341-359.
  • Ethical Practices and Legal Challenges in Mental Health Research.Smita N. Deshpande, Vishwajit L. Nimgaonkar, Triptish Bhatia, Nagendra Narayan Mishra, Rajesh Nagpal & Lisa S. Parker - 2020 - Asian Bioethics Review 12 (2):87-102.
    Considerations of justice and concern for well-being support conducting mental health research and addressing ethical concerns specific to mental health research are critical. We discuss these concerns, provide recommendations to enable the ethical conduct of mental health research, and argue that participants’ interests should be given primary weight in resolving apparent dilemmas. We also comment on provisions of two legislative actions in India relevant to mental health research: Rights of Persons with Disability Act 2016 and the Mental Health Care Act (...)
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  • Personal Autonomy, Decisional Capacity, and Mental Disorder.Lubomira V. Radoilska - 2012 - In Lubomira Radoilska (ed.), Autonomy and Mental Disorder. Oxford University Press.
    In this Introduction, I situate the underlying project “Autonomy and Mental Disorder” with reference to current debates on autonomy in moral and political philosophy, and the philosophy of action. I then offer an overview of the individual contributions. More specifically, I begin by identifying three points of convergence in the debates at issue, stating that autonomy is: 1) a fundamentally liberal concept; 2) an agency concept and; 3) incompatible with (severe) mental disorder. Next, I explore, in the context of decisional (...)
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  • Autonomy and Depression.Lubomira Radoilska - 2013 - In K. W. M. Fulford, Martin Davis, George Graham, John Sadler, Giovanni Stanghellini & Tim Thornton (eds.), Oxford Handbook of Philosophy and Psychiatry. Oxford University Press. pp. 1155-1170.
    In this paper, I address two related challenges the phenomenon of depression raises for conceptions according to which autonomy is an agency concept and an independent source of justification. The first challenge is directed at the claim that autonomous agency involves intending under the guise of the good: the robust though not always direct link between evaluation and motivation implied here seems to be severed in some instances of depression; yet, this does not seem to affect the possibility of autonomous (...)
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  • Informed Consent and Justified Hard Paternalism.Emma Cecelia Bullock - 2012 - Dissertation, University of Birmingham
    According to the doctrine of informed consent medical procedures are morally permissible when a patient has consented to the treatment. Problematically it is possible for a patient to consent to or refuse treatment which consequently leads to a decline in her best interests. Standardly, such conflicts are resolved by prioritising the doctrine of informed consent above the requirement that the medical practitioner acts in accordance with the duty of care. This means that patient free choice is respected regardless as to (...)
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  • Exploring the Similarities and Differences Between Medical Assessments of Competence and Criminal Responsibility.Gerben Meynen - 2009 - Medicine, Health Care and Philosophy 12 (4):443-451.
    The medical assessments of criminal responsibility and competence to consent to treatment are performed, developed and debated in distinct domains. In this paper I try to connect these domains by exploring the similarities and differences between both assessments. In my view, in both assessments a decision-making process is evaluated in relation to the possible influence of a mental disorder on this process. I will argue that, in spite of the relevance of the differences, both practices could benefit from the recognition (...)
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  • Depression, Possibilities, and Competence: A Phenomenological Perspective. [REVIEW]Gerben Meynen - 2011 - Theoretical Medicine and Bioethics 32 (3):181-193.
    Competent decision-making is required for informed consent. In this paper, I aim, from a phenomenological perspective, to identify the specific facets of competent decision-making that may form a challenge to depressed patients. On a phenomenological account, mood and emotions are crucial to the way in which human beings encounter the world. More precisely, mood is intimately related to the options and future possibilities we perceive in the world around us. I examine how possibilities should be understood in this context, and (...)
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  • Assessing Decision-Making Capacity After Severe Brain Injury.Peterson Andrew - unknown
    Severe brain injury is a leading cause of death and disability. Following severe brain injury diagnosis is difficult and errors frequently occur. Recent findings in clinical neuroscience may offer a solution. Neuroimaging has been used to detect preserved cognitive function and awareness in some patients clinically diagnosed as being in a vegetative state. Remarkably, neuroimaging has also been used to communicate with some vegetative patients through a series of yes/no questions. Some have speculated that, one day, this method may allow (...)
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  • The Best Interest Standard: An Exhaustive Guide for Medical Decision Making in Pediatrics?Eva De Clercq & Katharina Ruhe - 2018 - American Journal of Bioethics 18 (8):69-71.
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  • Conceptions of Decision-Making Capacity in Psychiatry: Interviews with Swedish Psychiatrists.Manne Sjöstrand, Petter Karlsson, Lars Sandman, Gert Helgesson, Stefan Eriksson & Niklas Juth - 2015 - BMC Medical Ethics 16 (1):34.
    Decision-making capacity is a key concept in contemporary healthcare ethics. Previous research has mainly focused on philosophical, conceptual issues or on evaluation of different tools for assessing patients’ capacity. The aim of the present study is to investigate how the concept and its normative role are understood in Swedish psychiatric care. Of special interest for present purposes are the relationships between decisional capacity and psychiatric disorders and between health law and practical ethics.
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  • Assessing Decision-Making Capacity: A Primer for the Development of Hospital Practice Guidelines.Andrew M. Siegel, Anna S. Barnwell & Dominic A. Sisti - 2014 - HEC Forum 26 (2):159-168.
    Decision making capacity (DMC) is a fundamental concept grounding the principle of respect for autonomy and the practice of obtaining informed consent. DMC must be determined and documented every time a patient undergoes a hospital procedure and for routine care when there is reason to believe decision making ability is compromised. In this paper we explore a path toward ethically informed development and implementation of a hospital policy related to DMC assessment. We begin with a review of the context of (...)
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  • Evaluating Medico-Legal Decisional Competency Criteria.Demian Whiting - 2015 - Health Care Analysis 23 (2):181-196.
    In this paper I get clearer on the considerations that ought to inform the evaluation and development of medico-legal competency criteria—where this is taken to be a question regarding the abilities that ought to be needed for a patient to be found competent in medico-legal contexts. In the “Decisional Competency in Medico-Legal Contexts” section I explore how the question regarding the abilities that ought to be needed for decisional competence is to be interpreted. I begin by considering an interpretation that (...)
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