EXECUTIVE DYSFUNCTION AS A BARRIER TO AUTHENTICITY IN DECISION MAKING

摘要

OWEN, FREYENHAGEN, AND Martin (2018) present a novel discussion of the meaning of decision-making capacity (DMC). They frame their discussion in the context of deficits in executive function after traumatic brain injury, but their observations and suggestions for expansion of how DMC is appropriately assessed have potential implications for people with other disorders that can potentially affect executive functioning, including those with certain forms of neurodegenerative conditions (such as frontotemporal dementia) and some of those with serious mental illnesses such as schizophrenia or bipolar disorder (Dunn, Lindamer, Palmer, Schneiderman, & Jeste, 2001; Grimes, McCullough, Kunik, MoHnari, & Workman, 2000). Although not mentioned explicitly in their article, a key point in considering DMC as conceptualized by Owen et al. is the notion of authenticity of a choice (Brudney, 2009; Kim, 2011; Roberts, 2002). This is essentially the idea that the person has the capacity to make a choice in the particular situation at hand that reflects "who he or she really is"—his or her genuine values and longer standing preferences.