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Phenomenology

Is autonomy only a cognitive capacity test?

Lewis J, Holm S · Medicine, health care, and philosophy · 2022

Open access · cc by · source: Europe PMC

English capacity law treats autonomy as understanding, retaining, using and weighing information; phenomenology adds bodily and affective engagement as part of autonomous deciding.

Study at a glance

Design
Other — Phenomenological critique of English capacity-law autonomy as purely cognitive information-handling
N
Philosophical/legal-phenomenological analysis; not an empirical sample
Population
Informed consent and Mental Capacity Act decision-making standards
Outcome
Bodily and affective engagement as part of autonomous deciding beyond MCA cognitive tests

Structured fields used in claim comparison tables when every cited study has a complete layer.

Key findings

When patients fail deliberative competence tests, interference is more readily justified. The paper argues affective and bodily intentional capacities are necessary components of the capacity for autonomy, not extras. Layer-cake readings that split pre-predicative coping from propositional thought are discussed in the notes.

Methodology

The authors start from informed consent and the Mental Capacity Act 2005 test, then reject an introspective picture of phenomenology. Drawing on Heidegger and Merleau-Ponty, they take the phenomenological reduction as suspending the natural attitude so meaning shows up in practical, bodily, affective coping.

Limitations

This is legal-philosophical, not a new capacity instrument. It does not rewrite the MCA. Illness as unhomelike is cited via Svenaeus, not newly measured.

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • SupportsPhenomenologyconcept

    English capacity law’s cognitive test is too thin: bodily and affective engagement belong to autonomous deciding.

    Evidence for the claim as stated.

  • Applied to autonomy, the method adds bodily and affective engagement to the deliberative picture. One paper argues that the Mental Capacity Act's understand-retain-use-weigh test omits affective and bodily intentional capacities that are necessary components of autonomy, not extras; another argues that Beauchamp and Childress's account of autonomy as a property of decisions is too thin for end-of-life care, where decisions are better understood relationally and in clinical context.

    Evidence for the claim as stated.

  • Across the set, the output is an argument rather than a dataset. The papers describe themselves as essays, reconstructions or legal-philosophical analyses; none produces a clinical score, a cohort or a trial, and several say so explicitly in their limits.

    Evidence for the claim as stated.

  • How much non-philosophical material to bring in. Mehling and colleagues supplement conceptual analysis with interviews of leading practitioners; the pain, health and autonomy papers work from the philosophical tradition alone. The interview-backed paper still cannot show that enhancing awareness causes clinical benefit, so the extra material widens the description without turning it into a test.

    Evidence for the claim as stated.

Open questions

Tensions this paper is part of

From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.

  • Scope difference — different assays, populations, or outcomes

    How much non-philosophical material to bring in. Mehling and colleagues supplement conceptual analysis with interviews of leading practitioners; the pain, health and autonomy papers work from the philosophical tradition alone. The interview-backed paper still cannot show that enhancing awareness causes clinical benefit, so the extra material widens the description without turning it into a test.

Related papers in this topic

Same topic cluster — not a recommendation engine.