Ethics Governance
Ethics & Governance - Resources and Articles |
| Articles indexes: a | b | c | d | e | f | g | h | i | j | k | l | m | n | o | p | q | r | s | t | u | v | w | x | y | z | other | |
|
|
| Article - Abstract. To view full article click on the article title. | |
CBHD: Competence, Capacity, and Surrogate Decision-Making by Robert D. Orr Generally speaking, patients should make their own treatment decisions based on their understanding of the facts, the recommendations of their physicians, and their own personal values which likely are influenced by their cultural and religious beliefs. But what happens when an individual's ability to understand information or to make decisions becomes impaired? Who decides what medical interventions should and should not be employed? And how does that surrogate decision-maker know what the patient would want? Competence and Capacity We often use the terms "competence" and "capacity" (short for "decision-making capacity") interchangeably. However, they are not exactly the same. Competence is a legal term. Competence is presumed unless a court has determined that an individual is incompetent. A judicial declaration of incompetence may be global, or it may be limited (e.g., to financial matters, personal care, or medical decisions). Decision-making capacity, on the other hand, is a clinical term that is task-specific. A physician may determine that a patient does not have the capacity to make a decision for or against surgery for a hip fracture, but she may have the capacity to decide if she wants a sleeping pill or a laxative. How does a physician make a determination of capacity? We say, only half facetiously, that a generation ago a patient had capacity if he agreed with the doctor and lacked capacity if he disagreed. Full Article: http://www.cbhd.org/resources/healthcare/orr_2004-03-10.htm |
|
2006 Ethics-Governance.com |
|||