Philosophy 230
Answers to Study Questions:  Mary Northern

Note:  While some of the study questions are factual, others are evaluative.  The evaluative
questions can obviously be answered in a variety of ways, and you should not hesitate to
develop your own ideas.  Be sure to get back to me if you have any questions about
these answers.

1.  Mary is a 72-yr.-old woman who is admitted to the hospital with gangrene in both her feet.
       The doctors judge that she will almost certainly die without surgery to amputate her feet
       (though the surgery is risky).  However, she is refusing the surgery.  The question then is:
       Is she competent to refuse to have her feet amputated?  Should we respect her right
       to refuse?

2.  The Court of Appeals rules that she is not competent to refuse.  They emphasize the
       psychiatrist's finding that she is "functioning on a psychotic level" (362) regarding her
       feet, even though she is otherwise mentally healthy.  Mary insists that her feet are not
        dead and are getting better--thus denying a fact that is plain to everyone around her.
        So the court finds that she is not competent to make this decision, even though she might
        well be competent to make others.

3.  I'm inclined to think that she is not competent to make this decision.  It is hard to deny the
       irrational character of her beliefs about her feet.  Since she seems so completely unable to
       understand or accept the true condition of her feet, it seems reasonable to conclude that
       she is not able to make a competent decision in this case.  I think the most serious objection
       here would point to potential evidence that she is at some level aware of the condition of her
       feet.  For example, when the judges ask to look at her feet, she is quite resistant.  One might
       argue that this is evidence that, deep down, she does realize that they are dead and simply
       does not want to admit it to others.  If she does understand the condition of her feet, then
       perhaps she is competent to make the decision.  How would I respond to this objection?
       I don't think we can rule out the possibility that she does understand the condition of her
       feet, but the evidence here seems very tentative.  It is certainly not clear that she does
       understand.

       While I'm inclined to think she is not competent to make this decision, I want to add that
        it is not really clear to me that the amputation ought to be performed.  The surgery does
        greatly increase her chances for long-term survival, but there are very serious concerns
         about her mental health should she survive the surgery.