Three Kinds of Decision-Making Capacity for Refusing Medical Interventions
According to a standard account of patient decision-making capacity (DMC), patients can provide ethically valid consent or refusal only if they are able to understand and appreciate their medical condition and can comparatively evaluate all offered treatment options. We argue instead that some patient refusals can be capacitated, and therefore ethically authoritative, without meeting the strict criteria of this standard account-what we call comparative DMC. We describe how patients may possess burdens-based DMC for refusal if they have an overriding objection to at least one burden associated with each treatment option or goals-based DMC for refusal if they have an overriding goal that is inconsistent with treatment. The overridingness of a patient's objections to burdens, or of their commitment to a goal, can justify the moral authority of their refusal, even when a patient lacks some of the cognitive capacities that standard accounts of DMC involve.
| Errataetall: |
CommentIn: Am J Bioeth. 2022 Nov;22(11):100-102. - PMID 36332038 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
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| Enthalten in: |
The American journal of bioethics : AJOB - 22(2022), 11 vom: 02. Nov., Seite 73-83 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Navin, Mark Christopher [VerfasserIn] |
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| Links: |
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| Themen: |
Decision-making capacity |
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| Anmerkungen: |
Date Completed 08.11.2022 Date Revised 27.04.2023 published: Print-Electronic CommentIn: Am J Bioeth. 2022 Nov;22(11):100-102. - PMID 36332038 Citation Status MEDLINE |
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| doi: |
10.1080/15265161.2021.1941423 |
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| Förderinstitution / Projekttitel: |
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| 520 | |a According to a standard account of patient decision-making capacity (DMC), patients can provide ethically valid consent or refusal only if they are able to understand and appreciate their medical condition and can comparatively evaluate all offered treatment options. We argue instead that some patient refusals can be capacitated, and therefore ethically authoritative, without meeting the strict criteria of this standard account-what we call comparative DMC. We describe how patients may possess burdens-based DMC for refusal if they have an overriding objection to at least one burden associated with each treatment option or goals-based DMC for refusal if they have an overriding goal that is inconsistent with treatment. The overridingness of a patient's objections to burdens, or of their commitment to a goal, can justify the moral authority of their refusal, even when a patient lacks some of the cognitive capacities that standard accounts of DMC involve | ||
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