Bioethics 25 (6):326-333 (2011)
Abstract |
According to the principle of patient autonomy, patients have the right to be self-determining in decisions about their own medical care, which includes the right to refuse treatment. However, a treatment refusal may legitimately be overridden in cases where the decision is judged to be incompetent. It has recently been proposed that in assessments of competence, attention should be paid to the evaluative judgments that guide patients' treatment decisions.In this paper I examine this claim in light of theories of practical rationality, focusing on the difficult case of an anorexic person who is judged to be competent and refuses treatment, thereby putting themselves at risk of serious harm. I argue that the standard criteria for competence assess whether a treatment decision satisfies the goals of practical decision-making, and that this same criterion can be applied to a patient's decision-guiding commitments. As a consequence I propose that a particular understanding of practical rationality offers a theoretical framework for justifying involuntary treatment in the anorexia case
|
Keywords | competence anorexia nervosa rationality Jehovah's Witness treatment refusal capacity |
Categories | (categorize this paper) |
DOI | 10.1111/j.1467-8519.2009.01793.x |
Options |
![]() ![]() ![]() ![]() |
Download options
References found in this work BETA
No references found.
Citations of this work BETA
Autonomy, Rationality, and Contemporary Bioethics.Jonathan Pugh - 2020 - Oxford, UK: Oxford University Press.
The Ethics of Deep Brain Stimulation for the Treatment of Anorexia Nervosa.Hannah Maslen, Jonathan Pugh & Julian Savulescu - 2015 - Neuroethics 8 (3):215-230.
Do We Need a Threshold Conception of Competence?Govert den Hartogh - 2016 - Medicine, Health Care and Philosophy 19 (1):71-83.
Authenticity and the Stimulated Self: Neurosurgery for Anorexia Nervosa.Hannah Maslen, Jonathan Pugh & Julian Savulescu - 2015 - American Journal of Bioethics Neuroscience 6 (4):69-71.
Evaluating Medico-Legal Decisional Competency Criteria.Demian Whiting - 2015 - Health Care Analysis 23 (2):181-196.
View all 15 citations / Add more citations
Similar books and articles
The Not Unreasonable Standard for Assessment of Surrogates and Surrogate Decisions.Rosamond Rhodes & Ian Holzman - 2004 - Theoretical Medicine and Bioethics 25 (4):367-386.
A Broader Notion of Competent Decision Making in Respect to What Is in the Best Interests of Patients Affected by Anorexia.Floris Tomasini - 2010 - Philosophy, Psychiatry, and Psychology 17 (2):155-157.
Patient Autonomy in Emergency Medicine.Anne-Cathrine Naess, Reidun Foerde & Petter Andreas Steen - 2001 - Medicine, Health Care and Philosophy 4 (1):71-77.
An Economic Theory of Patient Decision-Making.Douglas O. Stewart & Joseph P. DeMarco - 2005 - Journal of Bioethical Inquiry 2 (3):153-164.
Anorexia and Refusal of Life-Saving Treatment: The Moral Place of Competence, Suffering, and the Family.Simona Giordano - 2010 - Philosophy, Psychiatry, and Psychology 17 (2):143-154.
The Medical Decision-Making Process and the Family: The Case of Breast Cancer Patients and Their Husbands.Roy Gilbar & Ora Gilbar - 2009 - Bioethics 23 (3):183-192.
Three Concepts of Patient Competence.Haavi Morreim - 1983 - Theoretical Medicine and Bioethics 4 (3).
Making Decisions About Life-Sustaining Medical Treatment in Patients with Dementia.Arthur R. Derse - 1999 - Theoretical Medicine and Bioethics 20 (1):55-67.
Patient Decision Making Competence: Outlines of a Conceptual Analysis. [REVIEW]Jos V. M. Welie & Sander P. K. Welie - 2001 - Medicine, Health Care and Philosophy 4 (2):127-138.
Analytics
Added to PP index
2010-01-05
Total views
121 ( #95,237 of 2,498,175 )
Recent downloads (6 months)
3 ( #212,239 of 2,498,175 )
2010-01-05
Total views
121 ( #95,237 of 2,498,175 )
Recent downloads (6 months)
3 ( #212,239 of 2,498,175 )
How can I increase my downloads?
Downloads