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  • Ethics of Medicine

     

    Campus der Universität Bielefeld
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Ethics of Medicine in Bielefeld

The research work of the group is oriented towards the existential questions of philosophy while also being focused on the practical requirements in clinical and regulatory practices in medicine. We are currently still in the process of building our team.

In the field of teaching, the group is collaborating with the History and Philosophy of Medicine (Prof. Dr. Lara Keuck) and Medical Law (Jun.-Prof. Dr. Friederike Gebhard) in establishing the new medical degree program.

Current topics

Annette Dufner, along with other experts, recommends a less restrictive approach to sedation requests at the end of life. See the article for more information.

Events

Guestlecture by Joseph Millum

Title:  Decision-making Capacity and Marginal Agency

Lecturer: Dr. Joseph Millum, University of St. Andrews (Host: Prof. Dr. Annette Dufner, AG 14 – Ethik der Medizin)

Room: UHG, Hörsaal 14,  Universitätsstraße 25, 33615 Bielefeld

 

Abstract:

Dr. Joseph Millum, University of St Andrews

(Based on work co-authored with Dr. Danielle Bromwich, University of Leeds)

When a person is judged to have decision-making capacity, they can consent for themselves, affording them a degree of control over their lives. They get to decide what they eat, where they live, with whom they associate, and what medical care they receive. A person who is judged to lack decision-making capacity has no right of control and others typically have authority to make certain decisions on their behalf. The stark difference in how we respect people’s rights makes it vitally important to know what justifies judgments about decision-making capacity. Cases of marginal agency—such as older children, persons with moderate cognitive impairments, or dementia patients—illuminate the difficulty of this line drawing. If allowed complete freedom, such individuals are at risk of making some very poor decisions. Yet, they have or retain values and can often be helped to make good decisions in the right environment.

In this talk, I analyze the normative basis of decision-making capacity. Full decision-making capacity entails two rights: first, the power to waive certain claim rights by giving consent; second, a claim against paternalistic interference by others. For example, a competent adult can waive their right against bodily trespass and thereby give an artist permission to tattoo them. Further, even if getting the tattoo is contrary to their interests, third parties are not permitted to interfere and forbid the person to get the tattoo. Most scholars and health care professionals assume that these two rights go together—if someone has the power to consent then they have a claim against paternalistic interference. In this talk, I argue against this common grounds view. The capacities that ground a rights waiver are not the same as those needed to ground a claim against others’ paternalistic interference. Separating these normative grounds allows for an analysis of decision-making capacity that recognizes and respects marginal autonomy without sacrificing the need to protect those with questionable decision-making capacity from harm.

 

Workshop with Bettina Schöne-Seifert, Joseph Millum and Danielle Bromwich

New Perspectives on Informed Consent

17.01.2024, University of Bielefeld, X-E0-209

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