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A Narrative Coherence Standard for the Evaluation of Decisional Capacity: Turning Back the Clock
Manuel Trachsel & Paul S. Appelbaum

In the target article of the present issue, Goldberg challenges the traditional four criteria for the evaluation of clinical decision-making capacity (understanding, appreciation, ability to reason, communication of decision) by arguing “that clinicians and bioethicists who evaluate decisional capacity face questions far deeper than the mere presence or absence of a patient’s informed consent...

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Brain-Computer Interfaces and the Philosophy of Action
Michael J. Young

It is the unique business of agents to act. But what does it take for an agent to act, and what unique conditions render an agent capable of acting? A remark of Wittgenstein’s proves useful in crystallizing this question: “…when ‘I raise my arm’, my arm goes up. And the problem arises: what is left over if I subtract the fact that my arm goes up from the fact that I raise my arm? (Are th...

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Target Article

How Bioethics and Case Law Diverge in Assessments of Mental Capacity: An Argument for a Narrative Coherence Standard
Aryeh L. Goldberg

Clinical assessments of mental capacity have long been guided by four basic cognitive criteria (understanding, appreciation, ability to reason, communication of decision), distilled directly from widespread legal precedent in common law cases of informed consent and refusal. This article will challenge the sufficiency of these legal criteria at the bedside on the assertion that clinicians and bioe...

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When Thinking is Doing: Responsibility for BCI-Mediated Action
Stephen Rainey, Hannah Maslen & Julian Savulescu

Technologies controlled directly by the brain are being developed, evolving based on insights gained from neuroscience, and rehabilitative medicine. Besides neuro-controlled prosthetics aimed at restoring function lost somehow, technologies controlled via brain-computer interfaces (BCIs) may also extend a user’s horizon of action, freed from the need for bodily movement. Whilst BCI-mediated acti...

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