Ethics consultation has become an integral part of the fabric of U.S. health care delivery. This article summarizes the second edition of the Core Competencies for Health Care Ethics Consultation report of the American Society for Bioethics and Humanities. The core knowledge and skills competencies identified in the first edition of Core Competencies have been adopted by various ethics consultation services and education programs, providing evidence of their endorsement as health care ethics consultation (HCEC) standards. This revised report was prompted (...) by thinking in the field that has evolved since the original report. Patients, family members, and health care providers who encounter ethical questions or concerns that ethics consultants could help address deserve access to efficient, effective, and accountable HCEC services. All individuals providing such services should be held to the standards of competence and quality described in the revised report. (shrink)

Meaningful work is a key element of positive functioning of employees, but what makes work meaningful? Based on research on self-determination theory, basic psychological needs, and prosocial impact, we suggest that there are four psychological satisfactions that substantially influence work meaningfulness across cultures: autonomy (sense of volition), competence (sense of efficacy), relatedness (sense of caring relationships), and beneficence (sense of making a positive contribution). We test the relationships between these satisfactions and perceived meaningful work in Finland (n = 594, employees (...) of several organizations), India (n = 342, collected through Mturk), and the USA (n = 373, collected through Mturk). Regression analyses show that – except for competence in USA – all four satisfactions are significantly and independently associated with meaningful work. Moreover, structural equation modeling shows that they fully mediated the relationship between occupational position and work meaningfulness in India and in the USA. In sum, the results support the importance of these four satisfactions in explaining the psychological underpinnings of meaningful work. (shrink)

Being incoherent is often viewed as a paradigm kind of irrationality. Numerous authors attempt to explain the distinct-seeming failure of incoherence by positing a set of requirements of structural rationality. I argue that the notion of coherence that structural requirements are meant to capture is very slippery, and that intuitive judgments – in particular, a charge of a distinct, blatant kind of irrationality – are very imperfectly correlated with respecting the canon of structural requirements. I outline an alternative strategy for (...) explaining our patterns of normative disapproval, one appealing to feasible dispositions to conform to substantive, non-structural norms. A wide range of paradigmatic cases of incoherence, I will argue, involve manifesting problematic dispositions, dispositions that manifest across a range of cases as blatant-seeming normative failures. (shrink)

BackgroundEthical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that (...) promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.MethodsIn this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.ResultsThe review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.ConclusionsThe review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations. (shrink)

This study uses theories of moral reasoning and moral competence to investigate how university codes of ethics, perceptions of ethical culture, academic pressure from significant others, and ethics pedagogy are related to the moral development of students. Results suggest that ethical codes and student perceptions of such codes affect their perceptions of the ethical nature of the cultures within these institutions. In addition, faculty and student discussion of ethics in business courses is significantly and positively related to moral competence among (...) students. Our results point to the need to further examine the connections among academic institutional structures, ethics pedagogy, and students’ moral development. (shrink)

From the perspective of praxeological scientific research as well as quantitative methods and on the basis of archival materials, it becomes apparent that it is not in the ›geistesgeschichtliche‹ method, but in the implicit recognition of disciplinary, methodological, and theoretical plurality that the unity of literary studies lies that the DVjs expects from its articles.

According to what we propose to call “the competence model,” competence is a necessary condition for valid informed consent. If a person is not competent to make a treatment decision, the decision must be made by a substitute decision-maker on her behalf. Recent reports of various United Nations human rights bodies claim that article 12 of the Convention on the Rights of Persons with Disabilities involves a wholesale rejection of this model, regardless of whether the model is based on a (...) status, outcome, or functional approach to competence. The alleged rationale of this rejection is that denying persons the right to make their own treatment decisions based on an assessment of competence necessarily discriminates against persons with mental disorders. Based on a philosophical account of the nature of discrimination, we argue that a version of the competence model that combines supported decision-making with a functional approach to competence does not discriminate against persons with mental disorders. Furthermore, we argue that status- and outcome-based versions of the competence model are discriminatory. (shrink)

Robot ethics encompasses ethical questions about how humans should design, deploy, and treat robots; machine morality encompasses questions about what moral capacities a robot should have and how these capacities could be computationally implemented. Publications on both of these topics have doubled twice in the past 10 years but have often remained separate from one another. In an attempt to better integrate the two, I offer a framework for what a morally competent robot would look like and discuss a number (...) of ethical questions about the design, use, and treatment of such moral robots in society. Instead of searching for a fixed set of criteria of a robot’s moral competence I identify the multiple elements that make up human moral competence and probe the possibility of designing robots that have one or more of these human elements, which include: moral vocabulary; a system of norms; moral cognition and affect; moral decision making and action; moral communication. Juxtaposing empirical research, philosophical debates, and computational challenges, this article adopts an optimistic perspective: if robotic design truly commits to building morally competent robots, then those robots could be trustworthy and productive partners, caretakers, educators, and members of the human community. Moral competence does not resolve all ethical concerns over robots in society, but it may be a prerequisite to resolve at least some of them. (shrink)

Cultural competence literature and training aim to equip healthcare workers to better understand patients of different cultures and value systems, in an effort to ensure effective and equitable healthcare services for diverse patient populations. However, without nuanced awareness and contextual knowledge, the values embedded within cultural competence practice may cripple rather than empower the very people they mean to respect. A narrow cultural view can lessen cultural understanding rather than grow it. In its first part, this paper argues that a (...) hasty, unrestrained, and uneducated willingness to accept something as a cultural good, despite being well intentioned, can still cause significant harms—particularly when based on false, misinformed, and stereotypical conceptions—including the minimization of issues, the reinforcement of stereotypes, and the impediment of cultural change. The second part of this paper examines medical autonomy within the context of Saudi Arabian women. It pushes back on the common perception that Saudi women, by virtue of culture and religion, view dependency on and deference to male relatives as a cultural good. Through a historical examination and a presentation of the current women’s movement in Saudi Arabia, it is argued that the continued assumption that personal agency is a value external to Saudi women is false, misguided, and ethically problematic. Lastly, this paper considers some approaches to help providers navigate the narrow grounds between paternalism and patronization when caring for patients. (shrink)

Groups do better at reasoning tasks than individuals, and, in some cases, do even better than any of their individual members. Here is an illustration. In the standard version of Wason selection task (Wason, 1966), the most commonly studied problem in the psychology of reasoning, only about 10% of participants give the correct solution, even though it can be arrived at by elementary deductive reasoning.1 Such poor performance begs for an explanation, and a great many have been offered. What makes (...) the selection task relevant here is that the difference between individual and group performance is striking. Moshman & Geil for instance (1998, see also Maciejovsky & Budescu, 2007) had participants try and resolve the task either individually or in groups of five or six participants. While, unsurprisingly, only 9% of the participants working on their own found the correct solution, an astonishing 70% of the groups did. Moreover, when groups were formed with participants who had first tried to solve the task individually, 80% of the groups succeeded, including 30% of the groups in which none of the members had succeeded on his or her own. How are such differences between individual and group performance to be explained? (shrink)

Research ethics principles and regulations typically have been applied to the protection of individual human subjects. Yet, new paradigms of research that include the place-based community and cultural groups as partners or participants of environmental research interventions, in particular, require attention to place-based identities and geographical contexts. This paper argues the importance of respecting “place” within human subjects protections applied to communities and cultural groups as part of a critical need for research ethics and cultural competence training for graduate research (...) students. These protections and benefits are extensions of the Belmont Principles and have been included in recent recommendations from research regulatory committees. (shrink)

This discussion paper continues the debate over risk‐related standards of mental competence which appears in Bioethics 5. Dan Brock there defends an approach to mental competence in patients which defines it as being relative to differing standards, more or less rigorous depending on the degree of risk involved in proposed treatments. But Mark Wicclair raises a problem for this approach: if significantly different levels of risk attach, respectively, to accepting and refusing the same treatment, then it is possible, on this (...) account, for a patient to be considered competent to accept, but not refuse, the treatment, or vice versa. I argue that this puzzle does not constitute a genuine problem for a risk‐related standard. To this end I focus on the situation where, of two mutually exclusive options, one is riskier, but offering more pronounced benefit, while the other is safer, but offering less benefit. I argue for this proposition: it can take far less insight to know that the safe option is good than to know that the risky option is better. Now say one is actually informed enough to know that the safe option is good, but not enough to know whether the risky option is better; in such a case one is competent to say yes to that first option (the safe one), but not to say yes to the other. (I argue in passing that Pascal's Wager can be interpreted as having precisely this deliberative structure.) I thus conclude that cases do indeed exist where one can be competent to say yes but not no, or vice versa; and that it is thus not an anomaly in the risk‐related standard that it entails the existence of such cases. (shrink)

This chapter explores the suggestion that early attachment underpins the human capacity for empathy, and that empathy, in turn, is a condition of moral competence. We are disposed by nature to seek intimacy with our human conspecifics: the securely attached child learns that, whatever perils the world may hold, his well-being is shielded within the private sphere of personal intimacy. But why should secure attachment also favour—as it does—recognition of moral obligations towards those with whom we have no special standing (...) and share no personal destiny—recognition that the claims of persons as such merit our attention and regard? One answer to this question looks beyond the fact of secure attachment to a further psychological capacity, our capacity for empathy: secure attachment promotes susceptibility to empathy, and an appropriate susceptibility to empathy is a condition of basic moral competence. The chapter proposes that the deeper and more persisting significance of empathy to morality can be understood from a developmental perspective. Looking to mentalization-based attachment theory allows us to understand how empathic mirroring enters into our earliest intimate, interactions with other persons, securing our default commitment to recognizing their reality as bound up with our own. In this way, empathy constitutes one of the natural foundations on which the more complex architecture of moral experience is constructed. Attachment theory helps us to understand the indispensable role empathy plays at the beginning of the circuitous road to virtue. (shrink)

Linguistic intuitions are a central source of evidence across a variety of linguistic domains. They have also long been a source of controversy. This chapter aims to illuminate the etiology and evidential status of at least some linguistic intuitions by relating them to error signals of the sort posited by accounts of on-line monitoring of speech production and comprehension. The suggestion is framed as a novel reply to Michael Devitt’s claim that linguistic intuitions are theory-laden “central systems” responses, rather than (...) endorsed outputs of a modularized language faculty (the “Voice of Competence”). Along the way, it is argued that linguistic intuitions may not constitute a natural kind with a common etiology; and that, for a range of cases, the process by which intuitions used in linguistics are generated amounts to little more than comprehension. (shrink)

In a time marked by the development of innovative treatments in healthcare and the need for health professionals to deal with resulting ethical dilemmas in clinical practice, this study was developed to determine the influence of the bioethics teaching on the moral competence of medical and nursing students. The authors conduct a longitudinal study using the Moral Competence Test extended version before and after attending the ethics curricular unit, in three nursing schools and three medical schools of Portugal. In this (...) questionnaire the participant is confronted with three ethical dilemmas and asked to evaluate arguments for and against the attitude of the main character. For both nursing and medical students, C-score was lower after the attendance of the ethics curricular units, with a statistically significant decrease in the total score for nursing students and a decrease not statistically significant for medical students. A multivariate analysis did not find any association between this decrease and gender, course, or age. The phenomenon of moral segmentation was observed, with better performance in the worker and judge dilemma, than in the doctor dilemma. These results highlight the need to reflect on the curricular strategies that can be implemented for health professionals to better develop moral competence and decision-making, allowing for the provision of humanized health care. (shrink)

Recent theorizing and research concerning the pragmatics of analogy in persuasion posits that it serves two communicative functions. Specifically, rebuttal analogy instrumentally functions as argument and also as a social attack device used to demean the competence or character of opponents. The study reported here empirically investigated message receivers' perceptions of rebuttal analogy users. Participants were exposed to one of four messages employing rebuttal analogy or to one of the same four messages with a nonanalogy version of the rebuttal argument. (...) As anticipated, the findings revealed that participants perceived the communicator employing rebuttal analogy as less ethical and less competent than communicators using nonanalogy counterparts. These results are discussed and future research is proposed. (shrink)

As a study involving diabetes care demonstrates, children sometimes have a much more sophisticated capacity for taking charge of their own health care decisions than is usually recognized in bioethics. Protecting these children from their disease means involving them in their treatment as much as possible, helping them to understand it and take responsibility for it so that they can navigate the multitude of daily decisions that become part of the diabetes medical regimen.

A large part of the debate around the right to refuse life-prolonging treatment of anorexia nervosa sufferers centers on the issue of competence. Whether or not the anorexic should be allowed to refuse life-saving treatment does not depend solely or primarily on competence. It also depends on whether the anorexic’s suffering is bearable or tractable, and on the degree of involvement of the family in the therapeutic process. Anorexics could be competent to refuse lifesaving treatment (Giordano 2008). However, the anorexic’s (...) refusal of life-saving treatment should not be respected purely because it is a competent decision. In fact, anorexia has two characteristics that weaken the strength of the principle .. (shrink)

Résumé : L’article propose une démarche méthodologique permettant d’identifier la réflexion professionnelle chez des stagiaires en formation à l’enseignement. En effet, la capacité d’analyser sa pratique de façon réflexive est une composante d’une compétence professionnelle à développer selon le Ministère de l’Éducation du Québec. Une certaine forme de réflexion chez les étudiants est donc à acquérir et, du point de vue des tuteurs de stage, à faire acquérir. Quels sont les critères implicites que les enseignants associés des écoles ou (...) les superviseurs universitaires identifient afin d’évaluer la présence ainsi que la qualité de la compétence réflexive chez le stagiaire ? L’étude identifie une dizaine de points de repère afin de favoriser chez les tuteurs de stage l’évaluation de la compétence réflexive de leurs stagiaires. L’article valide ces critères à partir d’un extrait de discours de stagiaire, puis confronte cet extrait à une autre approche, consistant à détecter des reconceptualisations chez les stagiaires pour dépister de la réflexion. Une certaine cohérence s’établit avec les critères empiriques d’identification de la réflexion identifiés par induction chez les tuteurs de stage. S’ensuit une discussion sur ces critères en lien avec les approches méthodologiques adoptées. La recherche utilise un devis qualitatif et s’appuie sur des entretiens semi-structurés. Abstract : This article proposes a methodological process aimed at identifying professional reflection among student teachers in teacher education. The ability to analyze one’s practice reflectively is a component of one of the professional competencies that must be developed according to Quebec’s Ministry of Education. A certain form of reflection must therefore be acquired by students, and, from the standpoint of practicum supervisors, it must be developed in students. What are the implicit criteria that mentor teachers in schools or university-based supervisors identify in order to assess the presence and quality of student teachers' reflective competence? This study identifies a dozen guideposts to assist supervisors in this direction. The article first validates these criteria based on an excerpt of a student teachers’ statements, then submits the same excerpt to another approach aimed at detecting the student teacher’s reconceptualizations with a view to pinpointing reflection. A certain degree of coherence is established with the empirical criteria for identifying reflection as identified inductively by practicum supervisors. A discussion follows on these same criteria in line with the methodological approaches adopted. This research is based on a qualitative study. (shrink)

Is native speaker variation in understanding complex sentences due to individual differences in working memory capacity or in syntactic competence? The answer to this question has very important consequences for both theoretical and applied concerns in linguistics and education. This book is distinctive in giving an historical and interdisciplinary perspective on the rule- based and experience-based debate and in supporting an integrated account. In the study reported here, variation was found to be due to differences in syntactic competence and the (...) author argues that sentence comprehension is a learned skill, displaying many of the general characteristics of cognitive skills. The book will be stimulating reading for psycholinguists, theoretical linguists, applied linguists and educators. (shrink)

Children's competence to refuse or consent to medical treatment or surgery tends to be discussed in terms of the child's ability or maturity. This paper argues that the social context also powerfully influences the child's capacity to consent. Inner attributes and external influences are discussed using an analogy of the genes and the stars.

There is a long tradition of drawing metaphysical conclusions from investigations into language. This paper concerns one contemporary variation on this theme: the alleged ontological significance of cognitivist truth-theoretic accounts of semantic competence. According to such accounts, human speakers’ linguistic behavior is in part empirically explained by their cognizing a truth-theory. Such a theory consists of a finite number of axioms assigning semantic values to lexical items, a finite number of axioms assigning semantic values to complex expressions on the basis (...) of their structure and the semantic values of their constituents, and a finite number of production schemata. The theory enables the derivation of truth-conditions for each sentence of the language: something of roughly the form ‘S is true iff P’.1 The claim that speakers stand in a cognitive relation to such theories is advanced, not as a conceptual analysis of semantic competence or understanding, but rather as an empirical hypothesis about human speakers in particular, one part of a broader empirical account of our linguistic competence and cognition generally. It therefore must mesh with the rest of our theorizing in these areas and whatever relevant data from neighboring inquiries there may be. The precise nature of the cognitive relation a speaker is supposed to bear to a truththeory is a matter of some dispute. I speak of ‘‘cognizing’’ (following. (shrink)

In this, the second of two articles outlining a theory of communicative competence, the author questions the ability of Chomsky's account of linguistic competence to fulfil the requirements of such a theory. ?Linguistic competence? for Chomsky means the mastery of an abstract system of rules, based on an innate language apparatus. The model by which communication is understood on this account contains three implicit assumptions, here called ?monologism?, ?a priorism?, and ?elementarism?. The author offers an outline of a theory of (...) communicative competence that is based on the negations of these assumptions. In opposing the first two assumptions he introduces distinctions, respectively, between semantic universals which process experiences and those that make such processing possible, and between semantic universals which precede all socialization and those that are linked to the conditions of potential socialization. Against elementarism, he argues that the semantic content of all possible natural languages does not consist of combinations of a finite number of meaning components. Differences in systems of classification preclude this, and such differences can be seen to infect all respects of intercultural comparison. Using the notion of ?performative utterance?, the author elucidates the role of dialogue?constitutive universals as part of the formal apparatus required of a?; speaker's capacity to communicate. He then notes what would be required of a general semantics based on a theory of communicative competence; and finally points out how this theory might be used for social analysis. (shrink)

The paper deals with the problem of future biology teachers’ vocational preparation process and shaping in them of those capacities that contribute to the conservation and enhancement of our planet’s biodiversity as a reflection of the leading sustainable development goals of society. Such personality traits are viewed through the prism of forming the future biology teachers’ professional and terminological competence. The main aspects and categories that characterize the professional and terminological competence of future biology teachers, including terminology, nomenclature, term, nomen (...) and term element, have been explained. The criteria and stages of shaping the future biology teachers’ professional and terminological competence during the vocational training process have been fixed. Methods, techniques, technologies, guiding principles and forms of staged work on the forming of an active terminological dictionary of students have been described and specified. The content of the distant special course “Latin. Botanical Terminology”, which provides training for future teachers to study the professional subjects and to understand of international scientific terminology, has been presented. It is concluded that the proper level of formation of the future biology teachers’ professional and terminological competence will eventually ensure the qualitative preparation of pupils for life in a sustainable development era. (shrink)

Procedural justifications of democracy emphasize inclusiveness and respect and by doing so come into conflict with instrumental justifications that depend on voters’ competence. This conflict raises questions about jury theorems and makes their standing in democratic theory contested. We show that a type of no-regret learning called meta-induction can help to satisfy the competence assumption without excluding voters or diverse opinion leaders on an a priori basis. Meta-induction assigns weights to opinion leaders based on their past predictive performance to determine (...) the level of their inclusion in recommendations for voters. The weighting minimizes the difference between the performance of meta-induction and the best opinion leader in hindsight. The difference represents the regret of meta-induction whose minimization ensures that the recommendations are optimal in supporting voters’ competence. Meta-induction has optimal truth-tracking properties that support voters’ competence even if it is targeted by mis/disinformation and should be considered a tool for supporting democracy in hyper-plurality. (shrink)

According to cognitivist truth-theoretic accounts of semantic competence, aspects of our linguistic behavior can be explained by ascribing to speakers cognition of truth theories. It's generally assumed on this approach that, however much context sensitivity speakers' languages contain, the cognized truththeories themselves can be adequately characterized context insensitively—that is, without using in the metalanguage expressions whose semantic value can vary across occasions of utterance. In this paper, I explore some of the motivations for and problems and consequences of dropping this (...) assumption. (shrink)

In this paper a tentative explanation of the competence of argumentation from an evolutionary point of view is offered. Because in contemporary argumentation theory and the informal logic approach the evolutionary perspective has been neglected, this paper gives an initial overview on the matter with the hope that core aspects of the argumentative faculty—such as argumentative normativity, the function of arguments, or fallacious moves, among others—can be seen differently afterwards. In order to specify the proposal, the main concepts considered are (...) the notion of collective intentionality, cooperation, reputation, niche construction and, of course, basic evolutionary terms. (shrink)

Georges Rey; XV*—Semantic Externalism and Conceptual Competence, Proceedings of the Aristotelian Society, Volume 92, Issue 1, 1 June 1992, Pages 315–334, https.

The Entrepreneurial University plays a central role in entrepreneurial ecosystems and actively influences the development of entrepreneurial human capital, which is a critical asset for many economies. There is thus a requirement for the identification and strengthening of entrepreneurial competences, but no previous studies have included any analysis of these competences in the university context using an approach based on profiles. The present study fills this gap by investigating the existence of different entrepreneurial profiles among students, based on their competences. (...) It also defines key competences that are critical for differentiating between these profiles and improving entrepreneurial competence levels more generally. To meet these objectives, a field research campaign was developed. Data on 1104 students from various degrees and faculties were collected and analyzed using a quantitative methodological approach. The results reveal the existence of four entrepreneurial competence profiles, namelylow profile,top profile,social profile, andgrit profile. Among as many as 12 possible entrepreneurial competences, the most prominent can explain to a large extent the entrepreneurial profiles of students; these are networking and professional social skills, community engagement, perseverance of effort, and consistency of interest. The results provide evidence of the importance of social capital andgrit. In addition to their contribution to the theory in this area and the development of the Entrepreneurial University paradigm, the results are also useful for the design of training strategies aimed at strengthening the levels of competence of students, thereby providing universities with tools to foster the creation of entrepreneurial human capital. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ought We to Require Emotional Capacity as Part of Decisional Competence?Paul S. Appelbaum* (bio)AbstractThe preceding commentary by Louis Charland suggests that traditional cognitive views of decision-making competence err in not taking into account patients’ emotional capacities. Examined closely, however, Charland’s argument fails to escape the cognitive bias that he condemns. However, there may be stronger arguments for broadening the focus of competence assessment to include emotional capacities, centering on (...) the ways in which emotions aid humans in processing information. Before emotional capacities are added to the list of functions essential for decisional competence, though, the feasibility and utility of such a reorientation must be demonstrated.To what extent ought persons’ capacities to experience emotion be taken into account when determining whether they should be deemed competent to make their own decisions? In the previous article, Louis Charland (1998) argues that traditional models of decision-making competence—of which the MacArthur Competence Treatment Study is a typical example—are mistaken in focusing narrowly on persons’ cognitive abilities to the neglect of emotional factors. In contrast, he suggests, constructs of competence ought explicitly to require a capacity to experience emotions, which he believes is central to meaningful decision making, before deeming persons competent.Charland, as he acknowledges, is not the first to suggest that the presence of some degree of emotional capacity is a necessary element of competence, but his argument is among the most elaborate to date and is certainly worth closer examination. Looked at carefully, however, Charland’s argument does not make quite the case for the determination of emotional capacity in competence assessment that he claims for it. Indeed, as I demonstrate below, Charland may share the same “pernicious [End Page 377] cognitive bias” that he ascribes to more traditional approaches. However, despite what I identify as the problems in Charland’s argument, others have raised more disturbing questions about the lack of attention to emotional issues in competence assessment. Thus, I am not ready to reject entirely the possibility that determinations of decisional competence ought to consider emotional factors. I conclude by outlining the questions that remain to be answered to identify more clearly the potential benefits of such an approach.The Construct of Decision-Making CompetenceSome preliminary comments about the nature of the dominant construct of decision-making competence may provide a useful frame for my response to Charland’s paper. Contemporary ideas of competence are tied inextricably to the ideal of self-determination in modern Western societies. Such societies are committed to respect for individual choice, both as a good in its own right and on the grounds that each person knows best what choices will maximize his or her own welfare. In general, therefore, states will not intervene to prevent persons from acting on their decisions, even when the choices they make—like the decision to smoke or to refuse potentially life-saving medical care—may objectively be thought to be detrimental to them.In some cases, however, the presumption that people will act in their own interests, as well as the notion that there is something intrinsically valuable in respecting their choices, fails (Buchanan and Brock 1989). When people’s minds are so disordered that they cannot be said to be making meaningful choices, other values come into play. Such people are called “incompetent.” When persons reach that point, the state’s interest in protecting its citizens becomes primary and someone else must make decisions on their behalf. Note that the size of this group must be sharply limited, lest a liberal society’s commitment to self-determination be undermined: There is no more profound infringement of the rights of citizens than the determination that they are incompetent. Thus, the criteria for incompetence must be selected in a deliberately narrow fashion—alternately, one might say that the standards for competence are made intentionally broad—so that all but a tiny percentage of citizens will be permitted to make decisions on their own.In the Anglo-American world, the process of formulating criteria of competence by and large has been left to the common law courts. Over the course of centuries they have identified the capacities that are, in... (shrink)

According to evidentialists about inferential justification, an agent’s evidence—and only her evidence—determines which inferences she would be justified in making, whether or not she in fact makes them. But there seem to be cases in which two agents would be justified in making different inferences from a shared body of evidence, merely in virtue of the different competences those agents possess. These sorts of cases suggest that evidence does not have the pride of place afforded to it by evidentialists; competence (...) seems to play at least as important a role as evidence in explaining which inferences an agent would be justified in making. -/- In this paper, I consider how two versions of evidentialism about inferential justification might try to account for the role of competence in inference, and I present problems specific to each version. I end by sketching and briefly defending an alternative to these evidentialist views, “inferential dogmatism”. While dogmatic views have gotten some attention in debates around non-inferential justification, they have largely been ignored in debates around inferential justification and are to that extent novel. (shrink)