Showing posts with label abusive relationships. Show all posts
Showing posts with label abusive relationships. Show all posts

Thursday, 22 June 2017

Mental Capacity in Relationship

Camillia Kong is Lecturer in Philosophy at the University of Kent and Research Associate at the Ethox Centre, University of Oxford. She researches and has published on moral and political philosophical issues around the medico-juridical concept of capacity, mental disorder, and intellectual impairment. Her recent work also examines ethical issues around psychiatric genomics.



What should medical and legal professionals do when a person with intellectual impairment chooses to remain within an abusive and disabling environment? Should these professionals even be considering the difference between relationships and care environments which promote or disable the autonomy of individuals with a learning disability or mental disorder? Or is this paternalism gone one step too far?



In my new book Mental Capacity in Relationship: Decision-making, dialogue, and autonomy I explore these complex issues through the prism of mental capacity legislation in England and Wales and human rights conventions. Legal developments have revealed a number internal and external criticisms around the concept of mental capacity: in England and Wales medico-juridical professionals protect the right of autonomy of those who pass a legal functional test of mental capacity, but how this test should be interpreted is subject to internal debate.

Some legal judgments suggest an intrapersonal focus of mental capacity, whilst others indicate that the promotion of autonomy amongst those with impairments should have an interpersonal focus, where mental capacity will depend on the relationships and communities around the individual in question. Moreover, with the advent of the UN Convention for the Rights of Persons with Disabilities (CRPD), external critiques charge that the concept of mental capacity represents outdated, paternalistic, and discriminatory attitudes towards those with impairments, fundamentally designed to undermine their right of autonomy.

Both these internal and external critiques are addressed in my defense of a relational concept of mental capacity, where relationships and intersubjective dialogue have an important impact on the decisional capacity of individuals with impairments. In the book, I recommend caution against disposing with the concept of mental capacity as endorsed by the ‘will and preferences’ interpretation of Article 12 in the CRPD and further argue that mental capacity cannot be reducible to abilities ‘within one’s own head’, despite this pre-eminent understanding in both theory and practice. Core philosophical ideas that are operationalised within mental capacity law – such as rights, rationality, autonomy, and beneficence – need not presume an individualistic focus, but can be interpreted relationally.