- Is Mr. Spock Mentally Competent? Competence to Consent and Emotion
Most contemporary models and tests for mental competence do not make adequate provision for the positive influence of emotion in the determination of competence. This most likely is due to a reliance on an outdated view of emotion according to which these models are essentially noncognitive. Leading developments in modern emotion theory indicate that this noncognitive theory of emotion is no longer tenable. Emotions, in fact, are essentially representational in a manner that makes them “cognitive” in an important sense. This requires a reassessment of the place of emotion in the theory of mental competence. Building on Benjamin Freedman’s “recognizable reasons” account of competence, it will be argued that (1) emotions form a class of recognizable reasons of their own, and (2) that competence to consent is a matter of practical, rather than theoretical, reasoning. Emotions, then, are an essential ingredient in mental competence, and the cognitive bias that permeates the theory of mental competence today must be rejected.
cognitive science, neuroscience, bioethics, clinical research
Imagine that you are an investigator in charge of enrolling prospective research subjects in a clinical trial. So far, all of the subjects you have interviewed have been deemed competent to consent to participate in the trial and all have given their informed consent. But the subject in front of you now is more problematic. While he appears perfectly competent, he maintains he is not. The reason provided: “I am basically incapable of really experiencing emotion.” The subject’s name is Mr. Spock.1
Is Mr. Spock mentally competent? Despite his own disclaimer to the contrary, many of us would probably answer the question in the affirmative. The reason is that in some respects Spock represents an important ideal of what it is to be mentally competent. A space-age child of the Enlightenment, he is the perfect cognizer. His thought processes are guided by logic alone, and almost completely free of the disruptive influences of emotion. With a profile like that, you would expect Spock to pass current tests for mental competence with flying colors. That includes many contemporary tests for determining competence to consent to research. So is Spock simply wrong when he claims that he is incompetent? Or is he right to believe that his inability to fully experience emotion is a sufficient reason for doubting his mental competence?
When emotions are mentioned in the literature on mental competence, it is usually because they are thought to influence competence negatively. They require attention in virtue of their capacity [End Page 67] to disrupt cognitive processes and compromise competence (Applebaum and Roth 1981; Buchanan and Brock 1989, 56; Culver et al. 1980; Harding et al. 1991). Because he is almost completely unable to experience emotion, Spock is exempt from these disruptive tempests. Hence our temptation to elevate him to the status of an ideal. There is in fact a venerable tradition in the history of emotion theory that corroborates the picture of emotions as dark and violent passions that impede rational thinking. That “noncognitive” view of emotion is reflected in many of our commonsense assumptions about the nature of human rationality and behavior. It is no surprise, then, to see it mirrored in many contemporary accounts of mental competence, where it translates into what might be called the “cognitivistic” approach to competence. Thus, a defining element of the cognitivistic approach to competence is its commitment to a “noncognitive” view of emotion. And with few exceptions, the cognitivistic approach is the dominant one today. In the words of one commentator, “the consensus is that competence to consent lies exclusively within the domain of the intellect” (White 1994, 71). The aim of this paper is to challenge that consensus and demonstrate that emotions have an important positive role to play in mental competence. The point is not that cognitivistic theories are hopelessly flawed and need to be abandoned. Rather, it is that they can be significantly strengthened and improved by adding emotion as a positive contributing component in competence.
Unfortunately, we must wait before we can decide whether Mr. Spock is mentally competent or not. First, we...