The notion of free will and its ethical relevance for decision-making capacity.

Authenticity Autonomy Compatibilism Competence Decision-making capacity Ethics Free will Harry Frankfurt Informed consent

Journal

BMC medical ethics
ISSN: 1472-6939
Titre abrégé: BMC Med Ethics
Pays: England
ID NLM: 101088680

Informations de publication

Date de publication:
08 05 2019
Historique:
received: 07 07 2018
accepted: 26 04 2019
entrez: 10 5 2019
pubmed: 10 5 2019
medline: 6 2 2020
Statut: epublish

Résumé

Obtaining informed consent from patients is a moral and legal duty and, thus, a key legitimation for medical treatment. The pivotal prerequisite for valid informed consent is decision-making capacity of the patient. Related to the question of whether and when consent should be morally and legally valid, there has been a long-lasting philosophical debate about freedom of will and the connection of freedom and responsibility. The scholarly discussion on decision-making capacity and its clinical evaluation does not sufficiently take into account this fundamental debate. It is contended that the notion of free will must be reflected when evaluating decision-making capacity. Namely, it should be included as a part of the appreciation-criterion for decision-making capacity. The argumentation is mainly drawn on the compatibilism of Harry Frankfurt. A solution is proposed which at the same time takes the notion of free will seriously and enriches the traditional understanding of decision-making capacity, strengthening its justificatory force while remaining clinically applicable.

Sections du résumé

BACKGROUND
Obtaining informed consent from patients is a moral and legal duty and, thus, a key legitimation for medical treatment. The pivotal prerequisite for valid informed consent is decision-making capacity of the patient. Related to the question of whether and when consent should be morally and legally valid, there has been a long-lasting philosophical debate about freedom of will and the connection of freedom and responsibility.
MAIN TEXT
The scholarly discussion on decision-making capacity and its clinical evaluation does not sufficiently take into account this fundamental debate. It is contended that the notion of free will must be reflected when evaluating decision-making capacity. Namely, it should be included as a part of the appreciation-criterion for decision-making capacity. The argumentation is mainly drawn on the compatibilism of Harry Frankfurt.
CONCLUSIONS
A solution is proposed which at the same time takes the notion of free will seriously and enriches the traditional understanding of decision-making capacity, strengthening its justificatory force while remaining clinically applicable.

Identifiants

pubmed: 31068168
doi: 10.1186/s12910-019-0371-0
pii: 10.1186/s12910-019-0371-0
pmc: PMC6505276
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

31

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Auteurs

Tobias Zürcher (T)

Institute for Biomedical Ethics and History of Medicine (IBME), University of Zurich, Winterthurerstrasse 30, CH-8006, Zürich, Switzerland.

Bernice Elger (B)

Center for Legal Medicine, University of Geneva, Geneva, Switzerland.
Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.

Manuel Trachsel (M)

Institute for Biomedical Ethics and History of Medicine (IBME), University of Zurich, Winterthurerstrasse 30, CH-8006, Zürich, Switzerland. manuel.trachsel@uzh.ch.
Psychiatric Outpatient Services, Thun, Switzerland. manuel.trachsel@uzh.ch.

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