The Inadequacy of Incompetence
Culver, Charles M.
Milbank Quarterly. 1990; 68(4): 619-643.
It is commonly held that the competence of patients to make medical decisions is the principal concept for determining whether those decisions may be overruled. We disagree and argue that competence to make medical decisions is neither a necessary nor a sufficient condition for determining when it is morally justified to overrule patients' treatment refusals. It is not a necessary condition because it is morally justified to overrule some patients who are, on many standard definitions of "competence," entirely competent to refuse. It is not a sufficient condition because the fact that a patient is not competent to refuse does not by itself morally justify overruling his refusal.
Allowing to Die; Artificial Feeding; Autonomy; Beneficence; Competence; Comprehension; Consent; Decision Making; Depressive Disorder; Electroconvulsive Therapy; Informed Consent; Involuntary Commitment; Moral Policy; Paternalism; Patient Care; Patients; Physicians; Policy Analysis; Risks and Benefits; Standards; Treatment Refusal;
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