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Competence and paternalism.

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  • Author(s): DeMarco JP;DeMarco JP
  • Source:
    Bioethics [Bioethics] 2002 Jun; Vol. 16 (3), pp. 231-45.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 8704792 Publication Model: Print Cited Medium: Print ISSN: 0269-9702 (Print) Linking ISSN: 02699702 NLM ISO Abbreviation: Bioethics
    • Publication Information:
      Publication: Oxford : Wiley-Blackwell
      Original Publication: Oxford ; New York : Basil Blackwell, c1987-
    • Subject Terms:
      Ethical Analysis* ; Mental Competency* ; Paternalism* ; Personal Autonomy* ; Risk* ; Treatment Refusal*/legislation & jurisprudence; Amputation, Surgical ; Gangrene/surgery ; Humans ; Informed Consent/legislation & jurisprudence
    • Abstract:
      Some bioethicists have argued in favor of a sliding scale notion of competence, paternalistically requiring greater competence in relation to more significant risk. I argue against a sliding scale notion, taking issue with the positions of Allen E. Buchanan and Dan W. Brock, Ian Wilkes, and Joel Feinberg. Rejecting arguments that a sliding scale is supported by legal cases, by ordinary usage, and by fallible judgments about competence, I argue in favor of greater evidence of competence when risk is greater. Two clinical cases are examined, both involving amputation, to show that my fixed concept of competence, with a requirement of clearer evidence of competence when risk is high, better accounts for good moral decisions in bioethics.
    • Contributed Indexing:
      Indexing Agency: KIE Local ID #: 103409.
      Keywords: Analytical Approach; Professional Patient Relationship
      Note: 30 fn. Note: KIE Bib: treatment refusal
    • Publication Date:
      Date Created: 20020905 Date Completed: 20020909 Latest Revision: 20221207
    • Publication Date:
      20240513
    • Accession Number:
      10.1111/1467-8519.00283
    • Accession Number:
      12211247