Three Kinds of Decision-Making Capacity for Refusing Medical Interventions.

Document Type

Article

Publication Date

11-2022

Publication Title

American Journal of Bioethics

Abstract

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.

Volume

22

Issue

11

First Page

7

Last Page

83

DOI

10.1080/15265161.2021.1941423

ISSN

1536-0075

PubMed ID

34344267

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