Mental capacity and the applied phenomenology of judgement
Mental capacity and the applied phenomenology of judgement
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DOI：
10.1007/s11097-011-9242-y
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发表时间：
2013-03-01
影响因子：
2.3
通讯作者：
Hickerson, Ryan
中科院分区：
文献类型：
--
作者：
Martin, Wayne;Hickerson, Ryan
我们承诺带来现象学的观点承担当代法律和临床实践的挑战。在各种各样的情况下，要求法律和医疗专业人员评估个人在为自己作出决定时行使自己判断的能力或能力。我们专注于关于同意或拒绝医疗的决定，并将广泛认可的临床仪器MacCAT-T与更现象学上知情的方法进行对比。虽然MacCAT-T将注意力集中在个人认知表现标准上，但以第二人称现象学为导向的方法将时间、他人和身份在构成个人自主判断能力方面的复杂作用纳入了研究范围。我们的现象学分析对能力评估的实践和这一领域的进一步研究都有影响。能力评估的良好实践必须关注决策社区、分布式能力和时间能力，而对心智能力的研究如果把重点放在“两耳之间”，就会错过这一现象。我们通过考虑最近两个有争议的能力案例来说明我们的方法：一个涉及功能失调的决策社区中的认知残疾，第二个呈现偏执型精神分裂症条件下主管决策的可能性。
We undertake to bring a phenomenological perspective to bear on a challenge of contemporary law and clinical practice. In a wide variety of contexts, legal and medical professionals are called upon to assess the competence or capacity of an individual to exercise her own judgement in making a decision for herself. We focus on decisions regarding consent to or refusal of medical treatment and contrast a widely recognised clinical instrument, the MacCAT-T, with a more phenomenologically informed approach. While the MacCAT-T focuses attention on individual cognitive performance criteria, an approach oriented by second-person phenomenology brings into view the complex role of time, others and identity in constituting the capacity for individual autonomous judgement. Our phenomenological analysis has consequences both for the practice of capacity assessments and for further research in this arena. Good practice in capacity assessment must attend to decision communities, distributed capacity, and temporal competence, while research on mental capacity will miss the phenomenon if it trains its focus 'between the ears.' We illustrate our approach by considering two recent cases of contested capacity: one involving cognitive disability in a dysfunctional decision community, the second presenting the possibility of competent decision-making under conditions of paranoid schizophrenia.