title: Do we need a threshold conception of competence?
abstract: On the standard view we assess a person's competence by considering her relevant abilities without reference to the actual decision she is about to make. If she is deemed to satisfy certain threshold conditions of competence, it is still an open question whether her decision could ever be overruled on account of its harmful consequences for her ('hard paternalism'). In practice, however, one normally uses a variable, risk dependent conception of competence, which really means that in considering whether or not to respect a person's decision-making authority we weigh her decision on several relevant dimensions at the same time: its harmful consequences, its importance in terms of the person's own relevant values, the infringement of her autonomy involved in overruling it, and her decision-making abilities. I argue that we should openly recognize the multi-dimensional nature of this judgment. This implies rejecting both the threshold conception of competence and the categorical distinction between hard and soft paternalism.
authors.affiliation: University of Amsterdam, Staten Bolwerk 16, 2011ML, Haarlem, The Netherlands. g.a.denhartogh@uva.nl.
authors.forename: Govert
authors.initials: G
authors.lastname: den Hartogh
mesh_terms: D035843:Biomedical Research / Q000941:ethics; D003657:Decision Making; D006801:Humans; D007600:Judgment / Q000941:ethics*; D016743:Mental Competency; D009014:Morals; D026706:Paternalism / Q000941:ethics*; D026684:Personal Autonomy; D035842:Research Subjects / Q000523:psychology
keywords: Competence; Decision-making ability; Decision-making authority; Hard paternalism; Soft paternalism; Threshold of competence; Variable standard of competence