Risk-related standards of competence are a nonsense.

Area of Science:

• Medical Ethics
• Philosophy of Medicine
• Decision-Making Capacity

Background:

• The principle of informed consent requires decision-making capacity.
• Risk relativism proposes that the level of capacity required may vary with the risks involved in a treatment choice.

Purpose of the Study:

• To critically evaluate the concept of risk relativity in medical decision-making.
• To assess the validity of "asymmetry," the idea that competence to consent to treatment differs from competence to refuse it.

Main Methods:

• Philosophical analysis of risk relativity and asymmetry.
• Examination of Rob Lawlor's "two-scale approach" from his 2016 JME article.
• Argumentation against the rational coherence of linking competence standards to risk levels.

Main Results:

• The study argues that risk relativity, as defended by Lawlor, is fundamentally flawed.
• The proposed "two-scale approach" for setting competence standards based on risk is deemed irrational.
• The concept of asymmetry, derived from risk relativity, is shown to be incoherent.

Conclusions:

• Risk relativity, which posits variable competence standards based on risk, is philosophically indefensible.
• The attempt to rationally link decision-making capacity to the level of risk is a "nonsense."
• The ethical implications of asymmetry in consent and refusal require re-evaluation due to the incoherence of risk relativity.