Jennifer Hawkins (2024) offers two cases that challenge traditional accounts of decision-making capacity, according to which respect for a medical decision turns on an individual’s cognitive capacities at the time the decision is made (Hawkins 2024; Appelbaum and Grisso 1988). In each of her described cases (involving anorexia nervosa and grief, respectively), a patient makes a decision that—although instrumentally rational at the time—does not reflect the patient’s longer-term values due to being in a particular psychological state. Importantly, this state does (...) not impair the patient’s cognition, but rather predisposes them to make a decision that conflicts with their own broader values, beliefs, or desires. (shrink)

Volume 24, Issue 8, August 2024, Page 124-126.

Volume 24, Issue 8, August 2024, Page 127-128.

A key objective of the law in the assessment of decision-making capacity in clinical settings is to allow clinicians and judges to avoid making value judgements about the reasons that patients use to refuse treatment. This paper advances two lines of argument in respect of this objective. The first is that authorities cannot rationally avoid significant evaluative judgements in the assessment of a patient’s own assessment of the facts of their case. Assessing reasoning is unavoidably value-laden. Yet the underlying motivation (...) behind clinicians’ and the law’s value-neutral aims, ie, the avoidance of undue paternalism, is worth preserving. That being so, the second line of argument will try to show that that underlying motivation is better served in a limited range of cases by embedding a ‘reversibility standard’ in the assessment process so that the patient can, if they wish, and in due course, bring about the consequences that they were prevented from realising as a result of a determination of incapacity. (shrink)

Volume 24, Issue 8, August 2024, Page 116-118.

Volume 24, Issue 8, August 2024, Page 83-85.

Volume 24, Issue 8, August 2024, Page 109-111.

Volume 24, Issue 8, August 2024, Page 121-123.

Volume 24, Issue 8, August 2024, Page 96-98.

Volume 24, Issue 8, August 2024, Page 98-100.

Volume 24, Issue 8, August 2024, Page 88-90.

Volume 24, Issue 8, August 2024, Page 106-108.

Volume 24, Issue 8, August 2024, Page 119-120.

Volume 24, Issue 8, August 2024, Page 90-93.

Volume 24, Issue 8, August 2024, Page 114-116.

Volume 24, Issue 8, August 2024, Page 101-103.

Volume 24, Issue 8, August 2024, Page 111-113.

Volume 24, Issue 8, August 2024, Page 103-106.