PP217 Lecture Notes - Lecture 6: Informed Consent
Problems due to limited competence
1.
Kinds of Limited Competence
○
Peoples abilities can vary over tie
○
When we're speaking of patient competence, we're speaking of '
the individual's ability to maintain, in a practical manner, her values
and fulfill her interests'
○
Requires an agent able to make practical decisions:
§
Ability to formulate accurate beliefs about the specific
situation in question
§
Ability to deliberate about concrete options and choose the
best based on her preferences and values
§
Have intentions that generally accord with her decisions
○
We have to examine potentially incompetent in the relevant sense-
ex; choice of medical treatment
2.
Protection from harm vs. protection from autonomy
○
It's a violation of autonomy to treat a competent person as though
she is not. Although, we may accidentally exploit people by allowing
them to consent when they are genuinely not able to
○
Seriousness of the consequences requires a high level of
competency in decision making
3.
Special moral cases vs. individual differences
○
Protecting incompetent people from exploitation by creating
'special moral cases'-declare that certain groups of people will be
treated differently
○
Others argue to treat individual cases
Medical experiments
1.
Therapeutic and non-therapeutic experiments
○
Therapeutic experiments are believed to offer some benefit
○
Non-therapeutic experiments are designed to advance knowledge
of people in general
○Some experiments are indirectly therapeutic, they offer the chance
of benefit
§Ex; research on polio vaccines
2. Informed consent and research
○Duty to obtain voluntary agreement to participate before the
beginning of treatment/ enrolment
○Duty to disclose adequate information to the participant before
they agree to participate
○The reason for obtaining consent is to respect an individuals right
not to participate
§Sreenivasan argues that since we would accept an individual's
ignorant decision not to participate, we should accept their
ignorant decision to participate
3. Social benefit of research
○Very challenging to determining the benefit
4. Justice in distribution of goods and evils
○Justice in access to individual benefits - may be the only hope left-
supports trials in developing countries
○Justice in benefits to groups- focus on the wider community would
not support trials in developing countries
Slippery Slope
• General form of the argument we should not do what is proposed,
because that is the first step down a slippery slope to bad consequences
○2 questions to pose when faced with this argument
1. Will the predicted slide really occur?
2. Is the result actually objectionable
• The first premise (that the slope is slippery) is an empirical claim, one
whose truth depends on some facts about the world, which can be
settled with the right observations
• The second claim (that the bottom of the slope is morally bad) is a moral
claim
• Sorites argument: may be claimed that the slide is inevitable because
there is no principled distinction between A and B
○Conclusion and premises are conceptual claims
Limited Competence & Medical Experiments
Saturday, June 30, 2018
8:42 AM
Document Summary
Problems due to limited competence: kinds of limited competence. When we"re speaking of patient competence, we"re speaking of " the individual"s ability to maintain, in a practical manner, her values and fulfill her interests" Requires an agent able to make practical decisions: Ability to formulate accurate beliefs about the specific situation in question. Ability to deliberate about concrete options and choose the best based on her preferences and values. Have intentions that generally accord with her decisions. We have to examine potentially incompetent in the relevant sense- ex; choice of medical treatment: protection from harm vs. protection from autonomy. It"s a violation of autonomy to treat a competent person as though she is not. Although, we may accidentally exploit people by allowing them to consent when they are genuinely not able to. Seriousness of the consequences requires a high level of competency in decision making: special moral cases vs. individual differences. Protecting incompetent people from exploitation by creating.
