Notes
1 Latent in the article is the assumption that these concepts (i.e., harm and wellbeing) are somehow objectively determined (perhaps under a “reasonable person” standard). How this can be reconciled with the reality of diverse, idiosyncratic patient preferences is unclear.
2 In advancing their arguments about incorporating externalism into competence evaluations as a supplement to the current internalist assessments, the authors neglect to examine whether current understandings or assessments of decisional capacity are appropriate to retain in clinical settings. Some may argue that the assessment of decisional competence in the medical setting should only be whether a patient can communicate their choice, especially in the context of treatment refusals (Wright Citation2022).