On the Relationship between Competence and Welfare

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This article refers to:

Harmful Choices, the Case of C, and Decision-Making Competence

Notes

1 For more on the possibility of decisions in the absence of competence, see Schwan (forthcoming, §2) (NB: Schwan does not distinguish between decision-making capacity and competence as Pickering et al. do).

2 To take just one example: “Making a judgment about whether someone has sufficient capacity—i.e. is competent—is, as we argue, where the external things, such as risk, have a role” (40).

3 It’s not exactly clear what Pickering et al mean by “non-normative.” We take them to mean something like “atypical,” though the details aren’t important in what follows.

4 Of course, even on this account there will be some cases in which we needn’t appeal to welfare considerations in making a judgment of (in)competence. For instance, we can be confident an unconscious patient is incompetent without appealing to the welfare considerations at stake. But even so, insofar as (a) the unconscious patient is incompetent because their capacity falls below the relevant threshold and (b) the relevant threshold is partly determined by welfare considerations, those welfare considerations are part of what it is for the patient to be incompetent. On the constitutive account, welfare considerations matter in principle even if they don’t always make a difference in practice.

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The authors reported there is no funding associated with the work featured in this article.