Autonomy, Competence and Non-interference

Roberts, Joseph Tarquin Foulkes

doi:10.1007/s10730-017-9344-1

Cited by 5 publications

(8 citation statements)

References 40 publications

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“…22 Drane, 1984Drane, , 1985Buchanan andBrock, 1986, 1989;Feinberg, 1986;Eastman and Hope, 1988;Brock, 1991;Skene, 1991;Winick, 1991;Schopp, 1994;Wilks, 1997Wilks, , 1999Grisso and Appelbaum, 1998;Saks, 1999;Berghmans, 2001;Buchanan, 2004;Howe, 2010;Kim, 2010;Bolt and van Summeren, 2014;den Hartogh, 2016;Roberts, 2018…”

Section: Substantivementioning

confidence: 99%

“…This, however, should not be confused with 'lowering the bar' for incapacity." (Berghmans, 2001) 13 Drane, 1984Drane, , 1985Buchanan andBrock, 1986, 1989;Feinberg, 1986;Eastman and Hope, 1988;Winick, 1991;Schopp, 1994;Wilks, 1997;Berghmans, 2001;Kim, 2010;Roberts, 2018;Graber, 2021 CA3 Outcome alone does not determine DMC RS-DMC may include the outcome/choice itself as indicative of risk, but other factors are also essential to DMC assessment. "But outcome is not the standard of competence in this model.…”

Section: Underlying Framework Used By Authorsmentioning

confidence: 99%

“…Competence judgment determined by both internal abilities and other contextual or relational factors external to the abilities. 17 Buchanan andBrock, 1986, 1989;Feinberg, 1986;Eastman and Hope, 1988;Brock, 1991;Winick, 1991;Wilks, 1997Wilks, , 1999Grisso and Appelbaum, 1998;Berghmans, 2001;Buchanan, 2004;Saks and Jeste, 2006;Kim, 2010;Bolt and van Summeren, 2014;den Hartogh, 2016;Lawlor, 2016;Roberts, 2018 Internalist Competence judgment determined solely by level of abilities within the person 9 Kloezen et al, 1988;Culver and Gert, 1990;Wicclair, 1991aWicclair, ,b, 1999White, 1994;Cale, 1999;Maclean, 2000;Checkland, 2001 One step or two step…”

Section: Externalistmentioning

confidence: 99%

“…A finding of DMC gives an individual DA, so their decisions should be respected 17 Buchanan andBrock, 1986, 1989;Feinberg, 1986;Eastman and Hope, 1988;Kloezen et al, 1988;Brock, 1991;Skene, 1991;Winick, 1991;White, 1994;Wilks, 1997;Grisso and Appelbaum, 1998;Checkland, 2001;Buchanan, 2004;Kim, 2010;Bolt and van Summeren, 2014;den Hartogh, 2016;Roberts, 2018 No A finding of DMC means the person has the ability to make decisions. Whether their decision should be respected is a separate judgment.…”

Section: Yesmentioning

confidence: 99%

“…6 Buchanan and Brock, 1986;White, 1994;Grisso and Appelbaum, 1998;Cale, 1999;Buller, 2001;Roberts, 2018;Graber, 2021Both 9 Feinberg, 1986Skene, 1991;Saks, 1999;Wilks, 1999;Maclean, 2000;DeMarco, 2002;Howe, 2010…”

Section: Objectivementioning

confidence: 99%

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Should Assessments of Decision-Making Capacity Be Risk-Sensitive? A Systematic Review

Berens

Kim

2022

Front. Psychol.

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BackgroundThe concept of decision-making capacity (DMC) or competence remains controversial, despite widespread use. Risk-sensitive DMC assessment (RS-DMC)—the idea that the higher the risk involved in a decision, the greater the decisional abilities required for DMC—has been particularly controversial. We conducted a systematic, descriptive review of the arguments for and against RS-DMC to clarify the debate.MethodsWe searched PubMed/MEDLINE (National Library of Medicine), PsycInfo (American Psychological Association) and Philpapers, updating our search to February 15th, 2022. We targeted peer-reviewed publications in English that argue for or against RS-DMC. Two reviewers independently screened the publications and extracted data from each eligible manuscript.ResultsOf 41 eligible publications, 22 supported a risk-sensitive threshold in DMC assessment. Most arguments for RS-DMC rely on its intuitive appeal and practical merits. The arguments against RS-DMC primarily express concerns about paternalism and the seeming asymmetry between consent and refusal; critics of RS-DMC support epistemic, rather than substantive (i.e., variable threshold), risk-sensitivity; counterarguments responding to criticisms of RS-DMC address charges of paternalism and exhibit a notable variety of responses to the issue of asymmetry. Authors used a variety of frameworks regarding the definition of DMC, its elements, and its relation to decisional authority, and these frameworks were significantly associated with positions on RS-DMC. A limitation of our review is that the coding relies on judgment and interpretation.ConclusionThe review suggests that some of the debate about RS-DMC stems from differences in underlying frameworks. Most defenses of RS-DMC rely on its intuitive appeal, while most criticisms reflect concerns about paternalism or the asymmetry between consent and refusal. Defenses of RS-DMC respond to the asymmetry problem in a variety of ways. Further research is needed on the implications of underlying frameworks, the asymmetry problem, and the distinction between epistemic and substantive models of RS-DMC.

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Section: Substantivementioning

confidence: 99%

Section: Underlying Framework Used By Authorsmentioning

confidence: 99%

Section: Externalistmentioning

confidence: 99%

Section: Yesmentioning

confidence: 99%

Section: Objectivementioning

confidence: 99%

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Should Assessments of Decision-Making Capacity Be Risk-Sensitive? A Systematic Review

Berens

Kim

2022

Front. Psychol.

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How to Regulate the Right to Self-Medicate

Roberts

2020

HEC Forum

Self Cite

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In Pharmaceutical Freedom Professor Flanigan argues we ought to grant people self-medication rights for the same reasons we respect people's right to give (or refuse to give) informed consent to treatment. Despite being the most comprehensive argument in favour of self-medication written to date, Flanigan's Pharmaceutical Freedom leaves a number of questions unanswered, making it unclear how the safeguards Flanigan incorporates to protect people from harming themselves would work in practice. In this paper, I extend Professor Flanigan's account by discussing a hypothetical case to illustrate how these safeguards could work together to protect people from harms caused by their own ignorance or incompetence.

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What deserves our respect? Reexamination of respect for autonomy in the context of the management of chronic conditions

Enzo

Ôkita

Asai

2018

Med Health Care and Philos

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The global increase in patients with chronic conditions has led to increased interest in ethical issues regarding such conditions. A basic biomedical principle-respect for autonomy-is being reexamined more critically in its clinical implications. New accounts of this basic principle are being proposed. While new accounts of respect for autonomy do underpin the design of many public programs and policies worldwide, addressing both chronic disease management and health promotion, the risk of applying such new accounts to clinical setting remain understudied. However, the application of new accounts of respect for autonomy to clinical settings could support disrespectful attitudes toward or undue interference with patients with chronic conditions. Reconsidering autonomy and respect using Kantian accounts, this paper proposes respect for persons as an alternative basic bioethical principle to respect for autonomy. Unlike the principle of respect for persons in the Belmont Report, our principle involves respecting any patient's decisions, behaviors, emotions, or life-style regardless of his or her "autonomous" capabilities. Thus, attitudes toward patients should be no different irrespective of the assessment of their decisional or executive capabilities.

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Autonomy, Competence and Non-interference

Cited by 5 publications

References 40 publications

Should Assessments of Decision-Making Capacity Be Risk-Sensitive? A Systematic Review

Should Assessments of Decision-Making Capacity Be Risk-Sensitive? A Systematic Review

How to Regulate the Right to Self-Medicate

What deserves our respect? Reexamination of respect for autonomy in the context of the management of chronic conditions

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