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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... able to determine which patients are , and which are not , competent decision makers . Unless determinations of patient competence are possible , the validity of consents cannot be assured . THE PRESUMPTION OF COMPETENCE AND ...
... trigger of concern about patient competence is the inabil- ity to come to a decision . Patients may be able to understand facts and even appreciate their importance , yet be unable to 8 Competence in the Health Care Setting.
... able definition : ... no verbal formulation of a test can be made which will fit the standards laid down by the courts . So diverse is the phraseology of the test [ s ] by courts in different jurisdictions , and even by vari- ous ...
... able to do so . Clinicians and bioethicists need a clear understanding of compe- tence to consent . Without it , they cannot determine the appropriate person from whom to solicit consent or decide which principle— beneficence or ...
... able to ( 1 ) be informed , ( 2 ) fully understand their cir- cumstances , ( 3 ) relate their circumstances to their value structures , and ( 4 ) make principled choices to promote chosen Competence and the Principle of Respect for ...
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 |