Are you mentally competent enough to make vital decisions? Moreover, who gets to say if you are? These are some the questions I and other students in my neuroethics class were faced with while reading the case of man who had survived a life-threatening fire which had burned over 60% of his body. The wounds left by the accident left Don Cowart with in excruciating pain, so excruciating that he asked for his treatment to be stopped so he could die. Despite all his pleas, his request was rejected on the grounds that he was mentally incompetent. But really how do you judge if a person is capable of making, and be held accountable for certain decisions?
Turns out that a mere mental or physical diagnosis in and of itself is not sufficient to deem a person mentally incompetent. Rather, according to the Due Process in Competency Determinations Act, the proof of a cognitive impairment in either alertness or attention, information processing, thought processes, the ability to modulate mood and affect, should first be diagnosed by a neuropsychologist. However most psychometric tests used by neuropsychologist compare individual results to the general population's, which speaks to relativeness of the definition of mental competency. How mentally competent you are simply depends on how well you measure up to others. So should a child, obtaining scores comparable to an adult's, be held accountable for his/her actions and decisions? Could this child be considered an adult? These are some of the questions this process raises to my mind.
This measure of competence reminded me of taking the ACT. We all know that in order to get into the U, we had to take that wonderful standardized test and receive a high enough score to prove that we are competent enough to attend this school. Some schools place higher value in an ACT score, and some schools (including the U) give large scholarships to students who score exceptionally well on the ACT. However, other important attributes such as responsibility, work-ethic, organization, etc. can not be measured by the ACT. This raises questions about the validity of "competency" tests.
This is a fascinating topic to me as well. An area where this is becoming increasingly important is in Alzheimer's where living wills or health care directives are created at the beginning of the disease stage. Perhaps they state the person would not like to be kept on life-support and then later on, this decision is changed. Has the disease progressed enough that we don't accept this person's changed opinion? Which choice do we accept?
I find this topic extremely interesting. It has been a very important topic to whether who has the right or correctness to classify someone as "not competent enough" to complete a task or specific concept? To which standard is it correct to compare people to? Based on age? Based on maturity? These are all things that is important concepts to which we can classify actions, who has a say in whats right and wrong? It is a difficult topic.
I'm glad the topic of ACT was brought up, because for me it is hard to measure competence by a single test. The ACT is a test that measures what we know, yet many of us spent much time and money on study tips and classes for it, while some of us did not study at all. I don't think a test like this can accurately measure how smart a person is and it is not something we should put too much faith in.