Abstract
This chapter attempts to provide an overview of the most sensitive ethical issues concerning persons without the capacity to consent. First, it introduces a normative framework of decision making in the case of incapable persons. Different concepts of competence, incapacity, and personal autonomy are presented and their relationships analyzed. The introduction and conceptual framework are followed by the analysis of different areas of controversial practices involving persons unable to consent. Two different models of previously expressed wishes taking the form of advance directives are distinguished. These are living wills and continuing powers of attorney. It is shown that despite the importance given to advance directives in some international documents, they are legally binding and followed in practice only in a small minority of countries. The next section of this chapter deals with the reproductive issues in minors and people with learning difficulties. Two controversial practices are presented in this respect: the use of contraception and termination of pregnancy in minors as well as sterilization of people with learning difficulties. The following section concentrates on the controversies of involuntary hospitalization and involuntary treatment of persons with mental disorders. The last set of issues addressed deals with the development of moral standards for biomedical research ethics on incapable people. This type of research is very complex because it has to “bypass” the principle of informed consent, which is regarded to be the core of national and international research ethics guidelines.
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Gefenas, E., Tuzaite, E. (2014). Persons Without the Capacity to Consent. In: ten Have, H., Gordijn, B. (eds) Handbook of Global Bioethics. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2512-6_70
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