Affect, Value and Problems Assessing Decision-Making Capacity

Location: Zoom (register here)
Date: Thursday 19 November, 12:30 - 14:00
The new St Cross Special Ethics Seminars are jointly arranged by the Oxford Uehiro Centre and the Wellcome Centre for Ethics and Humanities.

Speaker: Jennifer Hawkins, Associate Research Professor of Philosophy at Duke University.

Title: "Affect, Value and Problems Assessing Decision-Making Capacity"

Abstract: Valid informed consent to treatment requires that the person giving consent have decision-making capacity or (what amounts to the same thing) must be mentally competent. To date the most influential model for both conceptualizing what capacity is, and for assessing it clinically, is the “four abilities model” developed by Thomas Grisso and Paul Appelbaum. Despite its popularity, however, this framework is flawed. It not infrequently delivers the wrong verdict in certain kinds of cases involving strong emotions and/or problematic values. Given that we want to (a) avoid objectionable forms of paternalism (b) avoid labeling as incompetent those who simply have unusual values and (c) avoid assuming that mental illness entails lack of capacity, it can seem as if there is no good solution to the problems posed by these cases. Nonetheless, there is a way we can proceed while avoiding these moral pitfalls. In this paper I first offer a better way of conceptualizing what it is we are trying to determine in capacity assessments, and then sketch an alternative way to assess capacity that avoids the moral pitfalls while yielding better, more plausible results in the problem cases.   

Speaker: Jennifer Hawkins, Ph.D. (Princeton University), is Associate Research Professor in the Department of Philosophy, Duke University and a core faculty member of the Trent Center for Bioethics, Humanities & History of Medicine, Duke University School of Medicine. Her research interests in philosophy focus on well-being, happiness, theories of emotion and practical reason, and notions of self. Her interests in medical ethics are focused on disability, the care of patients with dementia, assessment of decision-making capacity, psychiatric illness, and the nature of suffering. She has published in a wide array of journals, including Ethics, Oxford Studies in Normative Ethics, Oxford Studies in Metaethics, Philosophical Quarterly, Philosophical Studies, Utilitas, The Hastings Center Report, and The Journal of Medicine and Philosophy. She was the recipient of a 2020-2021 fellowship from the American Council of Learned Societies, which is currently supporting her work on her book, Faring Well: A New Theory of Well-Being.