Competence and risk-relativity.
In this paper I discuss the view that the appropriate concept of competence is a decision-relative one: that a person may be competent to make one decision but not another. The argument that I present is that neither of the two competing theories supporting the decision-relative approach, internalism and externalism, can provide a coherent explanation of why a person's competence should be thought to be relative to a particular decision. On the one hand, internalism, which regards competence as exhaustively a matter of the person's understanding, fails to identify the specific skills or content that would warrant linking a specific decision with competence, and thus cannot provide an account of decision-relative that parallels task-relative. On the other hand, externalism, which regards competence as a matter of the person's understanding in relation to external elements such as risk, cannot adequately defend why a person's competence to make a decision should 'track' the level of probable harm that results from the decision.
Buller
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Philosophy Department, University of Alaska Anchorage.
D003071:Cognition; D032882:Comprehension; D003657:Decision Making; D006801:Humans; D007258:Informed Consent; D008020:Life Support Care; D016743:Mental Competency; D026706:Paternalism; D026684:Personal Autonomy; D012015:Reference Standards; D012306:Risk; D016312:Treatment Refusal