Competence to ConsentGeorgetown University Press, 16.09.1994 г. - 224 страници Free and informed consent is one of the most widespread and morally important practices of modern health care; competence to consent is its cornerstone. In this book, Becky Cox White provides a concise introduction to the key practical, philosophical, and moral issues involved in competence to consent. The goals of informed consent, respect for patient autonomy and provision of beneficent care, cannot be met without a competent patient. Thus determining a patient's competence is the critical first step to informed consent. Determining competence depends on defining it, yet surprisingly, no widely accepted definition of competence exists. White identifies nine capacities that patients must exhibit to be competent. She approaches the problem from the task-oriented nature of decision making and focuses on the problems of defining competence within clinical practice. Her proposed definition is based on understanding competence as occurring in a special rather than a general context; as occurring in degrees rather than at a precise threshold; as independent of consequential appeals; and as incorporating affective as well as cognitive capacities. Combining both an ethical overview and practical guidelines, this book will be of value to health care professionals, bioethicists, and lawyers. |
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... ( abilities ) . That is , one is competent to do a task if one pos- sesses the particular capacities that doing the task requires . For exam- ple , cardiovascular surgeons are competent if they have ( among others ) the capacities to ...
... abilities required for their successful completion . Likewise , persons are competent to consent if they possess certain capacities — those required for decision making in health care settings . Various suggestions have been made as to ...
... ability . Since Mrs. W is affected by stress , pain , and fear , most HCPs would not be sur- prised to hear Dr. X suggest that Mrs. W's refusal is not competent and should be ignored . But should we ignore her choice ? Was her refusal ...
... ability to complete her daily chores . Indeed , the vast majority of patients intend their encounters with HCPs to be brief but necessary interludes in their " real " lives . HCPs share this perspective and work to promote quick and ...
... abilities merely because the occasion for their use is a health care problem . If patients continue to demonstrate ... ability . Patients whose decision - making capacities are intractably absent or impaired are obviously incompetent ...
Съдържание
GENERAL VS SPECIFIC COMPETENCE | 83 |
THRESHOLD VS DECREE COMPETENCE | 95 |
CONSEQUENCEDEPENDENT VS CONSEQUENCEINDEPENDENT COMPETENCE | 106 |
COGNITIVE VS COGNITIVEAFFECTIVE COMPETENCE | 117 |
SUMMARY | 144 |
NOTES | 146 |
The Capacities that Define Competence to Consent | 154 |
INFORMABILITY AND DECISION MAKING | 157 |
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27 | |
MORAL IMPLICATIONS OF INFORMED CONSENT | 35 |
NOTES | 37 |
Current Confusion Surrounding the Concept of Competence | 44 |
CURRENT PROBLEMS WITH THE CONCEPT OF COMPETENCE | 53 |
SUMMARY | 74 |
NOTES | 75 |
Defining the Structure of Competence to Consent | 82 |
COGNITIVE AND AFFECTIVE CAPABILITY | 167 |
RESOLUTION AND RESIGNATION IN DECISION MAKING Resolution | 177 |
RECOUNTING ONES DECISIONMAKING PROCESS | 180 |
CONCLUSIONS | 183 |
Implications and Anticipated Criticisms | 185 |
ANTICIPATING THE CRITIC | 187 |
Bibliography | 193 |
Index | 203 |