‘Radical Interpretation’ and the Assessment of Decision-Making Capacity
Article first published online: 13 AUG 2013
© 2013 The Authors. Journal of Applied Philosophy published by John Wiley & Sons Ltd on behalf of Society for Applied Philosophy.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Journal of Applied Philosophy
Volume 30, Issue 4, pages 379–394, November 2013
How to Cite
Banner, N. F. and Szmukler, G. (2013), ‘Radical Interpretation’ and the Assessment of Decision-Making Capacity. Journal of Applied Philosophy, 30: 379–394. doi: 10.1111/japp.12035
- Issue published online: 22 OCT 2013
- Article first published online: 13 AUG 2013
The assessment of patients' decision-making capacity (DMC) has become an important area of clinical practice, and since it provides the gateway for a consideration of non-consensual treatment, has major ethical implications. Tests of DMC such as under the Mental Capacity Act (2005) for England and Wales aim at supporting autonomy and reducing unwarranted paternalism by being ‘procedural’, focusing on how the person arrived at a treatment decision. In practice, it is difficult, especially in problematic or borderline cases, to avoid a consideration of beliefs and values; that is, of the substantive content of ideas rather than simple ‘cognitive’ or procedural abilities.
However, little attention has been paid to how beliefs and values might be assessed in the clinical context and what kind of ‘objectivity’ is possible. We argue that key aspects of Donald Davidson's ideas of ‘Radical Interpretation’ and the ‘Principle of Charity’ provide useful guidance as to how clinicians might approach the question of whether an apparent disturbance in a person's thinking about beliefs or values undermines their DMC. A case example is provided, and a number of implications for clinical practice are discussed.