PHIL 2390H Lecture Notes - Lecture 3: Tylenol (Brand), Headache
26 Jun 2018
School
Department
Course
Professor
Module 3
The Importance of Competence
- Do you think pain can affect a patient’s competence to make medical decisions?
- Does a person’s level of intelligence and rationality affect medical decision making?
- Intelligence vs rationality (for example an infant does not have the intelligence to make
rational/competent medical decisions for themselves, others who are more
advanced/intelligent are certainly qualified in the sense that they understand the risks)
- Mental illness, certain drugs may affect your level of competence to make medical
decisions
Competence
- An individual’s ability to perform a particular task (i.e. you can ride a bicycle, you are
competent to ride a bicycle on the road)
- Competence to make medical decisions requires the rational, mentally mature decision
maker to
1) Be free from any internal or external constraints that might impede his ability to
understand the medical situation, prognosis, and treatment options and the risks of
treatment and non-treatment
2) Be able to make a decision and reflects his long-term settled values
- There is still disagreement about this definition
Deconstructing the definition
- Perform a task, in this case a ‘competent’ medical decision
oRational (how rational, what do we mean by rational?)
oMentally mature (What do we mean by mentally mature? Maybe at 18 yrs of
age…)
oFree from constraints (internal and external) to understanding
What kinds of constraints might impede this understanding? Pain might
be a problem, intelligence, medication…
oLong term settled values (competence might be when a decision matches one’s
long term settled values, although priorities might change when diagnosed with
a terminal illness and you may make decisions that are out of character)
Buchanan and Brock
- A minimal standard of competence (something that simply has a very specific
requirement):
oSuch a standard might be as simple as respecting the choice of anyone who is
able to express a preference (i.e. minimally competent if they can shake their
head ‘yes’ or ‘no’)
oWhat principles of biomedical ethics are supported or undermined by this
‘standard’? Might support one’s autonomy.
oWhat is problematic about this standard?
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Intelligence vs rationality (for example an infant does not have the intelligence to make rational/competent medical decisions for themselves, others who are more advanced/intelligent are certainly qualified in the sense that they understand the risks) Mental illness, certain drugs may affect your level of competence to make medical decisions. An individual"s ability to perform a particular task (i. e. you can ride a bicycle, you are competent to ride a bicycle on the road) Maybe at 18 yrs of age : free from constraints (internal and external) to understanding. An outcome standard of competence: the other extreme- this is kant"s standard, example- that the choice be reasonable or what a reasonable person would do, what principles of biomedical ethics are supported or undermined by this. A process standard of decision-making competence: requires that a patient can explain the reason(s) for their choice: central questions- how well must the patient understand and reason? and.
