Clinical Grice

Speranza

Herbert Paul Grice

Decision-Making Capacity: Who's to Say?

The law uses the concept of decision-making capacity (or competence) to determine whether a person’s decision to, for example, refuse medical treatment, should be respected. If a person can express a decision, understand the relevant information, appreciate how it applies to his case, and use and weigh it in deliberation, then he has decision-making capacity, and the refusal should be respected as his to make, and otherwise not.

Can one person judge of another person whether she has decision-making capacity without prejudice? For example, can we judge whether a patient has decision-making capacity without resting on the fact that their preference not to be treated is not what we judge to be in their best interests, or not what we think we would have wanted had we been in their shoes? Why or why not?