December 08, 2007

But WHO is Refusing the Treatment?

Family SculptureI blogged a while ago on CNE about whether sufferers of anorexia nervosa were competent to refuse treatment. It is a tricky issue, since they are not incompetent in the usual sense (inability to understand basic facts and reason from them) but the issue might be more that they hold what could perhaps be called pathological values: in many cases reasoning is fine, it is just that it is based on values, emotions or self-images that could be called irrational. This is not just a problem in AN, and it fits in with the richer and messier image of decisionmaking modern cognitive neuroscience is developing.

But it is problematic from an autonomy perspective. Traditional autonomy was assumed to be binary and not to have fussy edges (or a fuzzy core). Paternalists love to claim autonomy is not everything, but there does not seem to be any principled way of weighing different influences together.

I think figuring out how to think about autonomy, freedom, identity, responsibility and all the other high-level abstractions we build our ethical systems on in terms of the new neurocognitive findings, that is the prime problem for neuroethics.

Posted by Anders3 at December 8, 2007 05:03 PM