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  1. Competence in chronic mental illness: the relevance of practical wisdom.Guy A. M. Widdershoven, Andrea Ruissen, Anton J. L. M. van Balkom & Gerben Meynen - 2017 - Journal of Medical Ethics 43 (6):374-378.
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  • The Ethics of Deep Brain Stimulation for the Treatment of Anorexia Nervosa.Hannah Maslen, Jonathan Pugh & Julian Savulescu - 2015 - Neuroethics 8 (3):215-230.
    There is preliminary evidence, from case reports and investigational studies, to suggest that Deep Brain Stimulation could be used to treat some patients with Anorexia Nervosa. Although this research is at an early stage, the invasive nature of the intervention and the vulnerability of the potential patients are such that anticipatory ethical analysis is warranted. In this paper, we first show how different treatment mechanisms raise different philosophical and ethical questions. We distinguish three potential mechanisms alluded to in the neuroscientific (...)
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  • Conceptions of decision-making capacity in psychiatry: interviews with Swedish psychiatrists.Manne Sjöstrand, Petter Karlsson, Lars Sandman, Gert Helgesson, Stefan Eriksson & Niklas Juth - 2015 - BMC Medical Ethics 16 (1):34.
    Decision-making capacity is a key concept in contemporary healthcare ethics. Previous research has mainly focused on philosophical, conceptual issues or on evaluation of different tools for assessing patients’ capacity. The aim of the present study is to investigate how the concept and its normative role are understood in Swedish psychiatric care. Of special interest for present purposes are the relationships between decisional capacity and psychiatric disorders and between health law and practical ethics.
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  • Social Work and the Ethics of Involuntary Treatment for Anorexia Nervosa: A Postmodern Approach.Sacha Kendall & Richard Hugman - 2013 - Ethics and Social Welfare 7 (4):310-325.
    The debate on the ethics of involuntary treatment for Anorexia Nervosa (AN) is dominated by biomedical ethics approaches to the issues. In keeping with the biomedical ethics emphasis on objectively balancing ethical principles, the debate centres on how to respect the autonomy of persons with AN who refuse treatment whilst protecting these persons from harm. Commentators discuss this at a normative ethics level. Thus, the debate does not address the moral relevance of how knowledge is constructed in the practice environment (...)
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  • ‘Encounters with Experience’: Empirical Bioethics and the Future. [REVIEW]Jonathan Ives - 2008 - Health Care Analysis 16 (1):1-6.
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  • Decision making capacity should not be decisive in emergencies.Dieneke Hubbeling - 2014 - Medicine, Health Care and Philosophy 17 (2):229-238.
    Examples of patients with anorexia nervosa, depression or borderline personality disorder who have decision-making capacity as currently operationalized, but refuse treatment, are discussed. It appears counterintuitive to respect their treatment refusal because their wish seems to be fuelled by their illness and the consequences of their refusal of treatment are severe. Some proposed solutions have focused on broadening the criteria for decision-making capacity, either in general or for specific patient groups, but these adjustments might discriminate against particular groups of patients (...)
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  • Decision-Making Capacity and Authenticity.Tim Aylsworth & Jake Greenblum - 2024 - Journal of Bioethical Inquiry 21 (3):1-9.
    There is wide consensus among bioethicists about the importance of autonomy when determining whether or not a patient has the right to refuse life-saving treatment (LST). In this context, autonomy has typically been understood in terms of the patient’s ability to make an informed decision. According to the traditional view, decision-making capacity (DMC) is seen as both necessary and sufficient for the right to refuse LST. Recently, this view has been challenged by those who think that considerations of authenticity and (...)
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  • (1 other version)Anorexia Nervosa, Body Dissatisfaction, and Problematic Beliefs.Stephen Gadsby - 2023 - Review of Philosophy and Psychology 1:1-20.
    Body dissatisfaction has long been considered an integral component of and driving force behind anorexia nervosa. In this paper, I characterise body dissatisfaction in terms of problematic beliefs about body size and the value of thinness. I suggest two methods for understanding these beliefs. Regarding body size beliefs, I suggest focusing on certain forms of misleading phenomenal evidence that sufferers of anorexia nervosa are exposed to. Regarding beliefs about the value of thinness, I suggest focusing on the benefits of such (...)
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  • Tube Feed or Not Tube Feed: Ethics beyond the Consult Question.Scott Nelson, Nina Current & Joan Henriksen - 2023 - American Journal of Bioethics 23 (8):104-107.
    In the described case, the consult requester, nurse Gloria, wants help with the question: “is it ethically justifiable to compel tube feeding over the objection of a young adult with anorexia nervo...
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  • Affect, Values and Problems Assessing Decision-Making Capacity.Jennifer Hawkins - 2023 - American Journal of Bioethics 24 (8):1-12.
    The dominant approach to assessing decision-making capacity in medicine focuses on determining the extent to which individuals possess certain core cognitive abilities. Critics have argued that this model delivers the wrong verdict in certain cases where patient values that are the product of mental disorder or disordered affective states undermine decision-making without undermining cognition. I argue for a re-conceptualization of what it is to possess the capacity to make medical treatment decisions. It is, I argue, the ability to track one’s (...)
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  • Journeying to Ixtlan: Ethics of Psychedelic Medicine and Research for Alzheimer’s Disease and Related Dementias.Andrew Peterson, Emily A. Largent, Holly Fernandez Lynch, Jason Karlawish & Dominic Sisti - 2023 - American Journal of Bioethics Neuroscience 14 (2):107-123.
    In this paper, we examine the case of psychedelic medicine for Alzheimer’s disease and related dementias (AD/ADRD). These “mind-altering” drugs are not currently offered as treatments to persons with AD/ADRD, though there is growing interest in their use to treat underlying causes and associated psychiatric symptoms. We present a research agenda for examining the ethics of psychedelic medicine and research involving persons living with AD/ADRD, and offer preliminary analyses of six ethical issues: the impact of psychedelics on autonomy and consent; (...)
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  • The values and rules of capacity assessments.Binesh Hass - 2022 - Journal of Medical Ethics 48 (11):816-820.
    This article advances two views on the role of evaluative judgment in clinical assessments of decision-making capacity. The first is that it is rationally impossible for such assessments to exclude judgments of the values a patient uses to motivate their decision-making. Predictably, and second, attempting to exclude such judgments sometimes yields outcomes that contain intractable dilemmas that harm patients. These arguments count against the prevailing model of assessment in common law countries—the four abilities model—which is often incorrectly advertised as being (...)
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  • The rationality of eating disorders.Stephen Gadsby - 2023 - Mind and Language 38 (3):732-749.
    Sufferers of eating disorders often hold false beliefs about their own body size. Such beliefs appear to violate norms of rationality, being neither grounded by nor responsive to appropriate forms of evidence. I defend the rationality of these beliefs. I argue that they are in fact supported by appropriate evidence, emanating from proprioceptive misperception of bodily boundaries. This argument has far‐reaching implications for the explanation and treatment of eating disorders, as well as debates over the relationship between rationality and human (...)
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  • Unlocking the Voices of Patients with Severe Brain Injury.Andrew Peterson, Kevin Mintz & Adrian M. Owen - 2022 - Neuroethics 15 (1):1-15.
    This paper critically examines whether patients with severe brain injury, who can only communicate through assistive neuroimaging technologies, may permissibly participate in medical decisions. We examine this issue in the context of a unique case study from the Brain and Mind Institute at the University of Western Ontario. First, we describe how the standard approach to medical decision making might problematically exclude patients with communication impairments secondary to severe brain injury. Second, we present a modified approach to medical decision making. (...)
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  • Harmful Choices, the Case of C, and Decision-Making Competence.Neil Pickering, GIles Newton-Howes & Greg Young - 2021 - American Journal of Bioethics 22 (10):38-50.
    In this paper, we make the case that a person who is considering or has already made a decision that appears seriously harmful to that person should in some cases be judged incapable of making that...
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  • (1 other version)Decision-Making Capacity.Jennifer Hawkins & Louis C. Charland - 2020 - Stanford Encyclopedia of Philosophy.
    Decision-Making Capacity First published Tue Jan 15, 2008; substantive revision Fri Aug 14, 2020 In many Western jurisdictions the law presumes that adult persons, and sometimes children that meet certain criteria, are capable of making their own medical decisions; for example, consenting to a particular medical treatment, or consenting to participate in a research trial. But what exactly does it mean to say that a subject has or lacks the requisite capacity to decide? This question has to do with what (...)
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  • Resolved and unresolved bioethical authenticity problems.Jesper Ahlin Marceta - 2020 - Monash Bioethics Review 38 (1):1-14.
    Respect for autonomy is a central moral principle in bioethics. It is sometimes argued that authenticity, i.e., being “real,” “genuine,” “true to oneself,” or similar, is crucial to a person’s autonomy. Patients sometimes make what appears to be inauthentic decisions, such as when anorexia nervosa patients refuse treatment to avoid gaining weight, despite that the risk of harm is very high. If such decisions are inauthentic, and therefore non-autonomous, it may be the case they should be overridden for paternalist reasons. (...)
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  • Physician Aid-in-Dying and Suicide Prevention in Psychiatry: A Moral Crisis?Margaret Battin & Brent M. Kious - 2019 - American Journal of Bioethics 19 (10):29-39.
    Involuntary psychiatric commitment for suicide prevention and physician aid-in-dying (PAD) in terminal illness combine to create a moral dilemma. If PAD in terminal illness is permissible, it should also be permissible for some who suffer from nonterminal psychiatric illness: suffering provides much of the justification for PAD, and the suffering in mental illness can be as severe as in physical illness. But involuntary psychiatric commitment to prevent suicide suggests that the suffering of persons with mental illness does not justify ending (...)
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  • Manipulating body representations with virtual reality: Clinical implications for anorexia nervosa.Stephen Gadsby - 2019 - Philosophical Psychology 32 (6):898-922.
    Anorexia nervosa patients exhibit distorted body-representations. Specifically, they represent their bodies as larger than reality. Given that this distortion likely exacerbates the condition, there is an obligation to further understand and, if possible, rectify it. In pursuit of this, experimental paradigms are needed which manipulate the spatial content of these representations. In this essay, I discuss how virtual reality technology that implements full-body variants of the rubber-hand illusion may prove useful in this regard, and I discuss some issues related to (...)
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  • A Non-Ideal Authenticity-Based Conceptualization of Personal Autonomy.Jesper Ahlin Marceta - 2019 - Medicine, Health Care and Philosophy 22 (3):387-395.
    Respect for autonomy is a central moral principle in bioethics. The concept of autonomy can be construed in various ways. Under the non-ideal conceptualization proposed by Beauchamp and Childress, everyday choices of generally competent persons are autonomous to the extent that they are intentional and are made with understanding and without controlling influences. It is sometimes suggested that authenticity is important to personal autonomy, so that inauthenticity prevents otherwise autonomous persons from making autonomous decisions. Building from Beauchamp and Childress’s theory, (...)
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  • Brainjacking in deep brain stimulation and autonomy.Jonathan Pugh, Laurie Pycroft, Anders Sandberg, Tipu Aziz & Julian Savulescu - 2018 - Ethics and Information Technology 20 (3):219-232.
    'Brainjacking’ refers to the exercise of unauthorized control of another’s electronic brain implant. Whilst the possibility of hacking a Brain–Computer Interface (BCI) has already been proven in both experimental and real-life settings, there is reason to believe that it will soon be possible to interfere with the software settings of the Implanted Pulse Generators (IPGs) that play a central role in Deep Brain Stimulation (DBS) systems. Whilst brainjacking raises ethical concerns pertaining to privacy and physical or psychological harm, we claim (...)
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  • What Justifies Judgments of Inauthenticity?Jesper Ahlin - 2018 - HEC Forum 30 (4):361-377.
    The notion of authenticity, i.e., being “genuine,” “real,” or “true to oneself,” is sometimes held as critical to a person’s autonomy, so that inauthenticity prevents the person from making autonomous decisions or leading an autonomous life. It has been pointed out that authenticity is difficult to observe in others. Therefore, judgments of inauthenticity have been found inadequate to underpin paternalistic interventions, among other things. This article delineates what justifies judgments of inauthenticity. It is argued that for persons who wish to (...)
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  • The Need for Authenticity-Based Autonomy in Medical Ethics.Lucie White - 2018 - HEC Forum 30 (3):191-209.
    The notion of respect for autonomy dominates bioethical discussion, though what qualifies precisely as autonomous action is notoriously elusive. In recent decades, the notion of autonomy in medical contexts has often been defined in opposition to the notion of autonomy favoured by theoretical philosophers. Where many contemporary theoretical accounts of autonomy place emphasis on a condition of “authenticity”, the special relation a desire must have to the self, bioethicists often regard such a focus as irrelevant to the concerns of medical (...)
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  • Deep Brain Stimulation, Authenticity and Value.Sven Nyholm & Elizabeth O’Neill - 2017 - Cambridge Quarterly of Healthcare Ethics 26 (4):658-670.
    In this paper, we engage in dialogue with Jonathan Pugh, Hannah Maslen, and Julian Savulescu about how to best interpret the potential impacts of deep brain stimulation on the self. We consider whether ordinary people’s convictions about the true self should be interpreted in essentialist or existentialist ways. Like Pugh et al., we argue that it is useful to understand the notion of the true self as having both essentialist and existentialist components. We also consider two ideas from existentialist philosophy (...)
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  • Depression, possibilities, and competence: A phenomenological perspective. [REVIEW]Gerben Meynen - 2011 - Theoretical Medicine and Bioethics 32 (3):181-193.
    Competent decision-making is required for informed consent. In this paper, I aim, from a phenomenological perspective, to identify the specific facets of competent decision-making that may form a challenge to depressed patients. On a phenomenological account, mood and emotions are crucial to the way in which human beings encounter the world. More precisely, mood is intimately related to the options and future possibilities we perceive in the world around us. I examine how possibilities should be understood in this context, and (...)
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  • (1 other version)Decision-making capacity.Louis C. Charland - 2011 - Stanford Encyclopedia of Philosophy.
    In many Western jurisdictions, the law presumes that adult persons, and sometimes children that meet certain criteria, are capable of making their own health care decisions; for example, consenting to a particular medical treatment, or consenting to participate in a research trial. But what exactly does it mean to say that a subject has or lacks the requisite capacity to decide? This last question has to do with what is commonly called “decisional capacity,” a central concept in health care law (...)
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  • (1 other version)Anorexia Nervosa, Body Dissatisfaction, and Problematic Beliefs.Stephen Gadsby - 2024 - Review of Philosophy and Psychology 15 (3):685-704.
    Body dissatisfaction has long been considered an integral component of and driving force behind anorexia nervosa. In this paper, I characterise body dissatisfaction in terms of problematic beliefs about body size and the value of thinness. I suggest two methods for understanding these beliefs. Regarding body size beliefs, I suggest focusing on certain forms of misleading phenomenal evidence that sufferers of anorexia nervosa are exposed to. Regarding beliefs about the value of thinness, I suggest focusing on the benefits of such (...)
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  • Teens and Research.Carolyn Plunkett Neuhaus - 2016 - Cambridge Quarterly of Healthcare Ethics 25 (4):659-673.
    Abstract:On seeing promising results in a small number of patients, some researchers are conducting trials to determine whether deep brain stimulation (DBS) is an effective treatment for anorexia nervosa (AN). This article asks whether we should open enrollment in trials of DBS for AN to adolescents. Despite concerns about informed consent, parental consent, and unforeseeable psychological sequelae, the article concludes that the risks to anorexic adolescents associated with participation in trials of DBS are reasonable considering the substantial risks of not (...)
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  • Getting from the Ethical to the Empirical and Back Again: The Danger of Getting it Wrong, and the Possibilities for Getting it Right: 2008 Bioethics Special Edition: Editorial 2. [REVIEW]Anna Smajdor, Jonathan Ives, Emma Baldock & Adele Langlois - 2008 - Health Care Analysis 16 (1):7-16.
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  • “Terminal Anorexia”, Treatment Refusal and Decision-Making Capacity.Anneli Jefferson - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (4):558-569.
    Whether anorexic patients should be able to refuse treatment when this refusal potentially has a fatal outcome is a vexed topic. A recent proposal for a new category of “terminal anorexia” suggests criteria when a move to palliative care or even physician-assisted suicide might be justified. The author argues that this proposed diagnosis presents a false sense of certainty of the illness trajectory by conceptualizing anorexia in analogy with physical disorders and stressing the effects of starvation. Furthermore, this conceptualization is (...)
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  • Non-Psychiatric Treatment Refusal in Patients with Depression: How Should Surrogate Decision-Makers Represent the Patient’s Authentic Wishes?Esther Berkowitz & Stephen Trevick - 2024 - HEC Forum 36 (4):591-603.
    Patients with mental illness, and depression in particular, present clinicians and surrogate decision-makers with complex ethical dilemmas when they refuse life-sustaining non-psychiatric treatment. When treatment rejection is at variance with the beliefs and preferences that could be expected based on their premorbid or “authentic” self, their capacity to make these decisions may be called into question. If capacity cannot be demonstrated, medical decisions fall to surrogates who are usually advised to decide based on a substituted judgment standard or, when that (...)
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  • Treatment over Objection (in Anorexia Nervosa): Capacity Is Not the Whole Story.Barrie J. Huberman - 2023 - American Journal of Bioethics 23 (8):101-104.
    Working through Esme Johnson’s case brings to light many of the elements that make for a rich and impactful clinical ethics consultation. The health and well-being of a young person, whether a fami...
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  • More than just filler: an empirically informed ethical analysis of non-surgical cosmetic procedures in body dysmorphic disorder.Natalie M. Lane - 2021 - Journal of Medical Ethics 47 (12):e30-e30.
    ObjectivesTo identify and analyse ethical considerations raised when individuals with body dysmorphic disorder consult for non-surgical cosmetic procedures.MethodsEthical analysis was conducted addressing the issues of best interests and capacity to consent for non-surgical cosmetic procedures in individuals with BDD. Analysis was informed by the findings of semistructured interviews with non-surgical cosmetic practitioners and mental health professionals.FindingsNon-surgical cosmetic interventions were viewed not to be in the best interests of individuals with BDD, as they fail to address core psychological issues, result in (...)
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  • An Ethical Reevaluation: Where Are the Voices of Those With Anorexia Nervosa and Their Families?Anthony Barnett, Wayne Hall & Adrian Carter - 2015 - American Journal of Bioethics Neuroscience 6 (4):73-74.
    The review by Müller and colleagues (2015) of published case studies of neurosurgical treatment of anorexia nervosa (AN) is generally sound. However, we believe that their, somewhat surprising, pro...
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  • Moving Perspectives on Patient Competence: A Naturalistic Case Study in Psychiatry.A. M. Ruissen, T. A. Abma, A. J. L. M. Van Balkom, G. Meynen & G. A. M. Widdershoven - 2016 - Health Care Analysis 24 (1):71-85.
    Patient competence, defined as the ability to reason, appreciate, understand, and express a choice is rarely discussed in patients with obsessive compulsive disorder, and coercive measures are seldom used. Nevertheless, a psychiatrist of psychologist may doubt whether OCD patients who refuse treatment understand their disease and the consequences of not being treated, which could result in tension between respecting the patient’s autonomy and beneficence. The purpose of this article is to develop a notion of competence that is grounded in clinical (...)
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  • Ist die Beihilfe zum Suizid auf der Grundlage des Wunsches, anderen nicht zur Last zu fallen, ethisch gerechtfertigt?Dr Julian Bleek - 2012 - Ethik in der Medizin 24 (3):193-205.
    Ein Argument gegen die ärztliche Beihilfe zum Suizid lautet, Patienten könnten sich um Suizidassistenz bemühen, weil sie sich als Belastung empfinden. Dabei wird die Selbstbestimmtheit eines so motivierten Todeswunsches in Frage gestellt. Ist dieses Argument überzeugungskräftig? Empirische Daten zeigen, dass die ärztliche Beihilfe zum Suizid auf der Grundlage dieses Motivs den ethischen Prinzipien der Sorge um das Patientenwohl und des Respekts vor der Autonomie des Patienten nicht widersprechen muss. Denn das Empfinden, anderen zur Last zu fallen, kann trotz adäquater palliativmedizinischer (...)
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  • Introduction: The Anorexia Enigmas.Jennifer Radden, Luigi Pastore & Sara Dellantonio - 2024 - Review of Philosophy and Psychology 15 (3):663-684.
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  • Sense of agency during and following recovery from anorexia nervosa.Manja M. Engel, Vivien Ainley, Manos Tsakiris, H. Chris Dijkerman & Anouk Keizer - 2022 - Consciousness and Cognition 103:103369.
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  • Einwilligungsfähigkeit: inhärente Fähigkeit oder ethisches Urteil?Helena Hermann, Manuel Trachsel & Nikola Biller-Andorno - 2016 - Ethik in der Medizin 28 (2):107-120.
    ZusammenfassungDie Bestimmung der Einwilligungsfähigkeit von Patienten beinhaltet weitreichende ethische und rechtliche Implikationen. Ausreichende Klärung des Begriffs ist daher unerlässlich. Solche Bemühungen gelten vorwiegend der Definition von Kriterien hinsichtlich relevanter mentaler Fähigkeiten. Grundlegendere Aspekte werden kaum explizit besprochen, so die Frage, ob Einwilligungsfähigkeit eher eine inhärente Fähigkeit oder ein ethisches Urteil bezeichnet. Zentral bei dieser Unterscheidung ist der Stellenwert ethischer Überlegungen die Zulässigkeit fürsorglicher Bevormundung betreffend. Geht man von einer inhärenten Fähigkeit aus, schließen solche Überlegungen an die Beurteilung von Einwilligungsfähigkeit an. (...)
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  • Emotion and Value in the Evaluation of Medical Decision-Making Capacity: A Narrative Review of Arguments.Helena Hermann, Manuel Trachsel, Bernice S. Elger & Nikola Biller-Andorno - 2016 - Frontiers in Psychology 7:197511.
    ver since the traditional criteria for medical decision-making capacity (understanding, appreciation, reasoning, evidencing a choice) were formulated, they have been criticized for not taking sufficient account of emotions or values that seem, according to the critics and in line with clinical experiences, essential to decision-making capacity. The aim of this paper is to provide a nuanced and structured overview of the arguments provided in the literature emphasizing the importance of these factors and arguing for their inclusion in competence evaluations. Moreover, (...)
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  • Response to Crisp and Sullivan-Bissett.Guy A. M. Widdershoven, Andrea Ruissen, Anton J. L. M. van Balkom & Gerben Meynen - 2017 - Journal of Medical Ethics 43 (6):382-383.
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  • Anorexia Nervosa: The Diagnosis: A Postmodern Ethics Contribution to the Bioethics Debate on Involuntary Treatment for Anorexia Nervosa.Sacha Kendall - 2014 - Journal of Bioethical Inquiry 11 (1):31-40.
    This paper argues that there is a relationship between understandings of anorexia nervosa (AN) and how the ethical issues associated with involuntary treatment for AN are identified, framed, and addressed. By positioning AN as a construct/discourse (hereinafter “AN: the diagnosis”) several ethical issues are revealed. Firstly, “AN: the diagnosis” influences how the autonomy and competence of persons diagnosed with AN are understood by decision-makers in the treatment environment. Secondly, “AN: the diagnosis” impacts on how treatment and treatment efficacy are defined (...)
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  • Unreasonable reasons: normative judgements in the assessment of mental capacity.Natalie F. Banner - 2012 - Journal of Evaluation in Clinical Practice 18 (5):1038-1044.
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  • Do we need a threshold conception of competence?Govert den Hartogh - 2016 - Medicine, Health Care and Philosophy 19 (1):71-83.
    On the standard view we assess a person’s competence by considering her relevant abilities without reference to the actual decision she is about to make. If she is deemed to satisfy certain threshold conditions of competence, it is still an open question whether her decision could ever be overruled on account of its harmful consequences for her (‘hard paternalism’). In practice, however, one normally uses a variable, risk dependent conception of competence, which really means that in considering whether or not (...)
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  • Authenticity and psychiatric disorder: does autonomy of personal preferences matter? [REVIEW]Manne Sjöstrand & Niklas Juth - 2014 - Medicine, Health Care and Philosophy 17 (1):115-122.
    In healthcare ethics there is a discussion regarding whether autonomy of personal preferences, what sometimes is referred to as authenticity, is necessary for autonomous decision-making. It has been argued that patients’ decisions that lack sufficient authenticity could be deemed as non-autonomous and be justifiably overruled by healthcare staff. The present paper discusses this issue in relation certain psychiatric disorders. It takes its starting point in recent qualitative studies of the experiences and thoughts of patients’ with anorexia nervosa where issues related (...)
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  • Euthanasia and assisted suicide for people with an intellectual disability and/or autism spectrum disorder: an examination of nine relevant euthanasia cases in the Netherlands.Irene Tuffrey-Wijne, Leopold Curfs, Ilora Finlay & Sheila Hollins - 2018 - BMC Medical Ethics 19 (1):17.
    Euthanasia and assisted suicide have been legally possible in the Netherlands since 2001, provided that statutory due care criteria are met, including: voluntary and well-considered request; unbearable suffering without prospect of improvement; informing the patient; lack of a reasonable alternative; independent second physician’s opinion. ‘Unbearable suffering’ must have a medical basis, either somatic or psychiatric, but there is no requirement of limited life expectancy. All EAS cases must be reported and are scrutinised by regional review committees. The purpose of this (...)
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  • What it is like to be manic: a response to Director.Nuala B. Kane - 2024 - Journal of Medical Ethics 50 (10):716-717.
    In a recent article, Director makes the case that many individuals with bipolar disorder have the capacity to consent to many decisions while acutely manic, even when those decisions are out of character and cause harm. Referring to recent qualitative evidence, I argue that Director overlooks a key mechanism of manic incapacity, an inflexible experience of the future that impairs one’s ability to value. Without attention to the illness-specific experience of decision-making, capacity assessments risk false negatives in people with mania.
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  • Should Neuroscience Inform Judgements of Decision-Making Capacity?Andrew Peterson - 2018 - Neuroethics 12 (2):133-151.
    In this article, I present an argument that suggests neuroscience should inform judgments of decision-making capacity. First, I review key behavioral and neurocognitive data to demonstrate that neuroscientific tests might be predictive of decision-making capacity, and that these tests might inform clinical judgments of capacity. Second, I argue that, consistent with the principles of autonomy and justice, such data should inform judgements of decision-making capacity. While the neuroscience of decision-making capacity still requires time to mature, there is strong reason to (...)
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  • Is physician-assisted suicide justifiable when the patient is worried about being a burden to others?Julian Bleek - 2012 - Ethik in der Medizin 24 (3):10.1007/s00481-011-0148-6.
    Ein Argument gegen die ärztliche Beihilfe zum Suizid lautet, Patienten könnten sich um Suizidassistenz bemühen, weil sie sich als Belastung empfinden. Dabei wird die Selbstbestimmtheit eines so motivierten Todeswunsches in Frage gestellt. Ist dieses Argument überzeugungskräftig? Empirische Daten zeigen, dass die ärztliche Beihilfe zum Suizid auf der Grundlage dieses Motivs den ethischen Prinzipien der Sorge um das Patientenwohl und des Respekts vor der Autonomie des Patienten nicht widersprechen muss. Denn das Empfinden, anderen zur Last zu fallen, kann trotz adäquater palliativmedizinischer (...)
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  • Risk-related standards of competence are a nonsense.Neil John Pickering, Giles Newton-Howes & Simon Walker - 2022 - Journal of Medical Ethics 48 (11):893-898.
    If a person is competent to consent to a treatment, is that person necessarily competent to refuse the very same treatment? Risk relativists answer no to this question. If the refusal of a treatment is risky, we may demand a higher level of decision-making capacity to choose this option. The position is known as asymmetry. Risk relativity rests on the possibility of setting variable levels of competence by reference to variable levels of risk. In an excellent 2016 article inJournal of (...)
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