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A Critical Analysis of Joseph Fins’ Mosaic Decisionmaking: A Response to “Mosaic Decisionmaking and Reemergent Agency after Severe Brain Injury” (CQ 27 (1))

Published online by Cambridge University Press:  17 September 2019

ANDREW PETERSON
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Abstract:

In this paper, the author argues that Joseph Fins’ mosaic decisionmaking model for brain-injured patients is untenable. He supports this claim by identifying three problems with mosaic decisionmaking. First, that it is unclear whether a mosaic is a conceptually adequate metaphor for a decisionmaking process that is intended to promote patient autonomy. Second, that the proposed legal framework for mosaic decisionmaking is inappropriate. Third, that it is unclear how we ought to select patients for participation in mosaic decisionmaking.

Keywords

brain injurybrain-injured patientsmosaic decisionmakingpatient autonomy
Type
Departments and Columns
Information
Cambridge Quarterly of Healthcare Ethics , Volume 28 , Special Issue 4: Clinical Neuroethics , October 2019 , pp. 725 - 736
Copyright
Copyright © Cambridge University Press 2019 

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Footnotes

Acknowledgments: This article responds to a presentation by Joseph Fins at the annual 2016 Neuroethics Network conference at the ICM Brain and Spine Institute, Paris, France. Fins’ presentation was subsequently published in 2018 in Cambridge Quarterly of Healthcare Ethics. I thank Charles Weijer, Cory E. Goldstein, an anonymous reviewer, and the audience of the 2018 Neuroethics Network conference for helpful comments and discussion. I thank Tomi Kushner and Yves Agid for inviting me to present my response to Fins’ work. This research is supported by the Greenwall Faculty Scholars program.

CQ welcomes readers’ comments on papers published in the journal, please send submissions to T. Kushner at kushnertk@gmail.com.

References

Notes

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51. See note 19, Fins 2018, at 172, emphasis added.

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54. See note 19, Fins 2018, at 171.

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