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Health Care Analysis

, Volume 23, Issue 2, pp 181–196 | Cite as

Evaluating Medico-Legal Decisional Competency Criteria

  • Demian Whiting
Original Article
  • 358 Downloads

Abstract

In this paper I get clearer on the considerations that ought to inform the evaluation and development of medico-legal competency criteria—where this is taken to be a question regarding the abilities that ought to be needed for a patient to be found competent in medico-legal contexts. In the “Decisional Competency in Medico-Legal Contexts” section I explore how the question regarding the abilities that ought to be needed for decisional competence is to be interpreted. I begin by considering an interpretation that takes the question to be asking about the abilities needed to satisfy an idealized view of competent decision-making, according to which decisional competency is a matter of possessing those abilities or attributes that are needed to engage in good or effective or, perhaps, substantially autonomous or rational decision-making. The view has some plausibility—it accords with the way decisional competency is understood in a number of everyday contexts—but fails as an interpretation of the question regarding the abilities that should be needed for decisional competence in medico-legal contexts. Nevertheless, consideration of why it is mistaken suggests a more accurate interpretation and points the way in which the question regarding the evaluation of medico-legal competency criteria is to be answered. Building on other scholarly work in the area, I outline in the “Primary and Secondary Requirements” section several requirements that decisional competence criteria ought to satisfy. Then, in the “Applying the Framework” section, I say something about the extent to which medico-legal competency criteria, as well as some models of decisional competency proposed in the academic literature, fulfil those requirements.

Keywords

Decisional authority Decisional competency Idealized views of competency Law Medico-legal contexts Mental Capacity Act 2005 Proportionality Necessity 

Notes

Acknowledgments

My thanks to Suzanne Uniacke, Paul Gilbert and two anonymous reviewers for their very helpful comments on earlier drafts of this paper.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.PhilosophyUniversity of HullHullUK

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