Authority, Autonomy, and Capacity

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This article refers to:

Three Kinds of Decision-Making Capacity for Refusing Medical Interventions

This article is referred to by:

Capacities to Refuse Treatment: A Reply

Notes

1 In sketching the standard (comparative) account, Navin et al. draw primarily on Appelbaum (2007). For what it’s worth, we’re skeptical that the systematic comparative judgments requirement should be considered to be an essential feature of the standard account, rather than an incidental feature of Appelbaum’s (arguably idealized) characterization of the abilities to understand, appreciate, and reason about relevant information. But for present purposes, we’ll set this concern aside.

2 Our reason to treat patients consistently with their values and our reason to respect their decisions are both plausibly characterized as reasons to respect autonomy. But they can come apart. Because the former reason is present regardless of a patient’s degree of decision making abilities, our focus in what follows will be on the reason we have to respect patients’ decisions as such. For more on the distinction between these two types of autonomy considerations, see Brudney and Lantos (2011), Enoch (2022), and Schwan (2022).

3 For a helpful discussion of the ways in which the abilities constitutive of DMC track the capacity for autonomous decision-making, see Faden and Beauchamp (1986, ch. 8).

4 For further development of this argument, see Fogal and Schwan (ms).

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Funding

The author(s) reported there is no funding associated with the work featured in this article.