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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... choose contrary to the recommended regimen . For discussions of this asymmetry , see Abernethy , 1984 , 1991 ; Appelbaum et al . , 1987 ; Appelbaum and Roth , 1981 ; Baumgarten , 1980 ; Buchanan , 1985 ; Buchanan and Brock , 1986 , 1989 ...
... choose to abide by moral laws . Without reason , people are like animals — unable to be moral or immoral . In sum , the ability to reason is the foundation of morality . As bearers of reason , persons are also inherently valuable.1 This ...
... choose to live alone or in community , to marry or remain single , to have children or not to have children , to ... Choosing in Terms of a Value Structure Persons use their value structures to guide their behavior through- out their ...
... choosing in terms of that value structure . Choices based on ethical principles are ethically principled ; choices ... chooses a therapeutic alternative that the HCP considers less than optimal , the HCP must not interfere when the ...
... choose a particular option ) . Autonomy requires that patients not be forced to make particular choices ( though they may be encouraged to do so ) . A word of caution . HCPs may be tempted to reason thusly : I will find out what the ...
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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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 |