Competency Judgments: Case Studies in Moral Perspective

Abstract

The value that we hold for others is shown, in part, in the ways that we express concern and respect for them. Our concern is revealed in the manner in which we care for their health, safety, and general welfare. Our respect, on the other hand, is for others as persons, with their own unique conceptions of themselves, of what gives their lives meaning, and their goals. If we are to respect the personhood and autonomy of others, we give priority to what they value and want, not to what we value and want for them or think that they ought to want. There obviously is possible tension between these two duties to promote another person’s welfare and to respect his wishes [26]. Our society functions with an assumption that people have the capacity for free choice. Thus, we assume, until shown otherwise, that a person knows his or her mind better than we, and is, therefore, entitled to act on his or her reasoning, even if the action reflects a ‘poor’choice based on preferences and choices that manifestly are not conducive to their health, safety, or welfare ([15], p. 2). Balancing the welfare of others with respect for their autonomy can be difficult in health care situations where a patient’s competency is questioned.