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Defending manic competence

A reply to Kane

Bibliographic Data

ID21514458
AuthorsSamuel Director (0000-0003-2632-3644, Leadership Studies, University of Richmond, Richmond, Virginia, USA, corresponding author)
Year2025
Volume51
Issue9
Pages653-654
Publication date2025-09-01
Open AccessNo
TypeARTICLE
VenueJournal of Medical Ethics (JOURNAL)
Journal identifiersISSN: 0306-6800 • E-ISSN: 1473-4257
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/jme-2025-110744
PMID39965908
OpenAlexW4407691140
LanguageEN
References cited3

In a recent paper in this journal, I defended the thesis that some, although not all, patients experiencing acute bipolar mania are competent to consent. I made this argument based on the fact that the burden of proof lies with those who want to make judgements of incapacity (because autonomy is the default option until proven otherwise). We then need to ask what the reasons are for claiming that manic patients are not competent. I surveyed and critiqued the two most common reasons offered in the literature, which are that manic patients are irrational or that their value shifts in mania are defunct in some way. I argued that for many manic patients, neither of these reasons is strong enough to justify removing their decision-making capacity. Kane (2024) replied to my paper. In this short response, I defend my original arguments from Kane’s objection

Autonomy · Bipolar disorder · Irrational number · Mania · Mood · Political science · Psychiatry · Psychotherapist · Computer Science · Healthcare Decision-Making and Restraints · Law · Medicine · Mental Health and Psychiatry · Patient Dignity and Privacy · Psychology · Social Psychology

  • Bipolar disorder and competence

    Samuel Director•Journal of Medical Ethics•2024

  • What it is like to be manic

    Nuala B Kane•Journal of Medical Ethics•2024

Highly citedNo

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