Evaluating medico-legal decisional competency criteria

Whiting, Demian

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.

Citation

Whiting, D. (2015). Evaluating medico-legal decisional competency criteria. Health care analysis, 23(2), 181-196. https://doi.org/10.1007/s10728-013-0258-z

• Journal Article Type: Article
• Online Publication Date: Jun 27, 2013
• Publication Date: Jun 1, 2015
• Deposit Date: Nov 13, 2014
• Publicly Available Date: Nov 23, 2017
• Journal: Health care analysis
• Electronic ISSN: 1573-3394
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 23
• Issue: 2
• Pages: 181-196
• DOI: https://doi.org/10.1007/s10728-013-0258-z
• Keywords: Decisional authority, Decisional competency, Idealized views of competency, Law, Medico-legal contexts, Mental Capacity Act 2005, Proportionality, Necessity
• Public URL: https://hull-repository.worktribe.com/output/471636
• Publisher URL: http://link.springer.com/article/10.1007%2Fs10728-013-0258-z
• Copyright Statement: ©2015 University of Hull
• Additional Information: Authors' accepted manuscript of article published in: Health care analysis, 2015, v.23, issue 2