 Part of what is involved in reasoning about a particular course of action and reaching a decision is weighing the risks and benefits associated with the likely consequences of proposed options. In health care contexts where consent is at issue, this normally amounts to a decisional problem that is framed in symmetrical terms: either one consents to a given treatment option, or one refuses that same option. This way of framing things seems to assume that both poles of the decision are symmetrical and that mental capacity necessarily remains fixed as one evaluates the two options. Yet this is an assumption that can be philosophically challenged.