On risk and decisional capacity.
Limits to paternalism are, in the liberal democracies, partially defined by the concepts of decision-making capacity/incapacity (mental competence/incompetence). The paper is a response to Ian Wilks's (1997) recent attempt to defend the idea that the standards for decisional capacity ought to vary with the degree of risk incurred by certain choices. Wilks's defense is based on a direct appeal to the logical features of examples and analogies, thus attempting to by-pass earlier criticisms (e.g., Culver & Gert, 1990) of risk-based standards. Wilks's argument is found wanting on the grounds that he misconstrues the logic of such capacity, especially in accounting for conceptual and pragmatic ties with issues of decisional authority. A diagnosis is offered as to the source of Wilks's error (the assumption that mental competence is a species of wider genus of "competence"), and an alternative way of accounting for risk within the predominant contemporary legal framework is sketched.
Checkland
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Ryerson Polytechnic University, Toronto, Ontario, Canada. dcheckla@acs.ryerson.ca
D002755:Choice Behavior; D032882:Comprehension; D004992:Ethics, Medical; D006801:Humans; D007258:Informed Consent; D016743:Mental Competency; D026706:Paternalism; D012306:Risk; D020458:Third-Party Consent