R W Momeyer | PubMed Health

PubMed1997

Should informed consent be based on rational beliefs?

Our aim is to expand the regulative ideal governing consent. We argue that consent should not only be informed but also based on rational beliefs. We argue that holding true beliefs promotes autonomy. Information is important insofar as it helps a person to hold the relevant true beliefs. But in order to hold the relevant true beliefs, competent people must also think rationally. Insofar as information is important, rational deliberation is important. Just as physicians should aim to provide relevant information regarding the medical procedures prior to patients consenting to have those procedures, they should also assist patients to think more rationally. We distinguish between rational choice/action and rational belief. While autonomous choice need not necessarily be rational, it should be based on rational belief. The implication for the doctrine of informed consent and the practice of medicine is that, if physicians are to respect patient autonomy and help patients to choose and act more rationally, not only must they provide information, but they should care more about the theoretical rationality of their patients. They should not abandon their patients to irrationality. They should help their patients to deliberate more effectively and to care more about thinking rationally. We illustrate these arguments in the context of Jehovah's Witnesses refusing life-saving blood transfusions. Insofar as Jehovah's Witnesses should be informed of the consequences of their actions, they should also deliberate rationally about these consequences.

Christianity↗

PubMed1990

Philosophers and the public policy process: inside, outside, or nowhere at all?

Three standard tasks undertaken by applied ethicists engaged in the public policy process are identifying value issues, clarifying concepts and meanings, and analyzing arguments. I urge that these should be expanded to include making specific moral judgments and advocating positions and policies. Three objections to philosophers/ethicists' engagement in the formation of public policy are advanced and evaluated: philosophers necessarily do public policy badly, doing it at all compromises one's integrity as a seeker after truth, and frequently participation is in the service of a repressive status quo that is structured simultaneously to preclude radical change and to co-opt ethicists. Finally, however, I argue that those who would be 'applied ethicists' cannot avoid all participation in some form of a public policy process; that engagement holds the hope as well for improved ethical theory; that the preferred form of participation is frequently from outside of establishment bodies; and that wherever philosophers do involve themselves in policy formulation, this is best done in the expanded sense urged at the outset.

Advisory Committees↗