Duke University.
Am J Bioeth. 2024 Aug;24(8):71-82. doi: 10.1080/15265161.2023.2224273. Epub 2023 Jun 26.
The dominant approach to assessing decision-making capacity in medicine focuses on determining the extent to which individuals possess certain core cognitive abilities. Critics have argued that this model delivers the wrong verdict in certain cases where patient values that are the product of mental disorder or disordered affective states undermine decision-making without undermining cognition. I argue for a re-conceptualization of what it is to possess the capacity to make medical treatment decisions. It is, I argue, . Using this idea, I demonstrate that it is possible to craft a solution for the problem cases-one that neither alters existing criteria in dangerous ways (e.g. does not open the door to various kinds of abuse) nor violates the spirit of widely accepted ethical constraints on decision-making assessment.
医学中评估决策能力的主流方法侧重于确定个体在多大程度上具有某些核心认知能力。批评者认为，在某些情况下，这种模式的判决是错误的，在这些情况下，患者的价值观是精神障碍或紊乱的情感状态的产物，这些价值观会破坏决策，而不会破坏认知。我主张重新概念化拥有做出医疗决策能力的含义。我认为，这是 。我使用这个概念证明，对于疑难案例，可以制定一个解决方案——既不会以危险的方式改变现有标准（例如，不会为各种滥用行为打开大门），也不会违反广泛接受的决策评估伦理约束的精神。
