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Competency: A Triaxial Concept

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Book cover Competency

Part of the book series: Philosophy and Medicine ((PHME,volume 39))

Abstract

The notion of ‘competency’ (in the sense of ‘mental competency’ or ‘decision-making capacity’) lies at the intersection of a number of important issues in contemporary medical ethics.1 ‘Competency’in its general sense is usually understood to be a precondition to the exercise of autonomous choice. An individual who is determined to be ‘incompetent’ may not be permitted to act in a way he perceives to be in his best interests, including the accepting and refusing of medical diagnostic and therapeutic procedures. Thus, a person who is in fact competent but found to be ‘incompetent’ may lose his right to self-determination. On the other hand, an individual who is in fact incompetent, may so act as to bring harm to himself; such a person is not functioning ‘autonomously’and protecting such an individual can be justified on the basis of a principle of beneficence.2 Though a determination of ‘incompetency’in its strict sense is a legal determination and is made by a judge, the determination typically rests on information and an interpretation of that information provided by medical personnel and in particular by psychiatrists. More significantly, many determinations of competency/incompetency that play important parts in patient management are made by attending physicians who are not psychiatrists.3 Thus not only ethical, legal, psychiatric, and social issues are involved in competency determinations, but also medical management decisions arise in these situations.

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Authors and Affiliations

  1. Dept. of Philosophy, George Washington University Washington, D.C., and University of Pittsburgh, Pittsburgh, Pennsylvania, USA

    Kenneth F. Schaffner

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  1. Kenneth F. Schaffner
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Editors and Affiliations

  1. Dept. of Philosophy, University of Colorado at Colorado Springs, USA

    Mary Ann Gardell Cutter

  2. Foundation for Interfaith Research and Ministry, USA

    Earl E. Shelp

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© 1991 Springer Science+Business Media Dordrecht

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Schaffner, K.F. (1991). Competency: A Triaxial Concept. In: Cutter, M.A.G., Shelp, E.E. (eds) Competency. Philosophy and Medicine, vol 39. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-3614-3_15

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  • DOI: https://doi.org/10.1007/978-94-011-3614-3_15

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-5603-8

  • Online ISBN: 978-94-011-3614-3

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