Appreciation and emotion: theoretical reflections on the MacArthur Treatment Competence Study

Kennedy Inst Ethics J. 1998 Dec;8(4):359-76. doi: 10.1353/ken.1998.0027.


When emotions are mentioned in the literature on mental competence, it is generally because they are thought to influence competence negatively; that is, they are thought to impede or compromise the cognitive capacities that are taken to underlie competence. The purpose of the present discussion is to explore the possibility that emotions might play a more positive role in the determination of competence. Using the MacArthur Treatment Competence Study as an example, it is argued that appreciation, a central theoretical concept in many contemporary approaches to competence, has important emotive components that are seldom sufficiently recognized or acknowledged. If true, this means that some leading contemporary accounts of competence need to be revised in order to make more adequate provision for the positive contribution of emotion.

MeSH terms

  • Cognition
  • Comprehension
  • Decision Making
  • Emotions*
  • Evaluation Studies as Topic
  • Goals
  • Humans
  • Informed Consent*
  • Mental Competency*
  • Patient Care
  • Patients
  • Reference Standards*
  • Risk
  • Risk Assessment
  • Social Values
  • Treatment Refusal