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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Страница 20
... desire satisfaction , and objective goodness . Hedonism argues that pleasure is always good ( and pain is always bad ) . Having to assert the goodness of pleasure may seem silly , 20 Ethical Foundations of Competence to Consent.
... desire satisfaction , and objective goodness . Hedonism argues that pleasure is always good ( and pain is always bad ) . Having to assert the goodness of pleasure may seem silly , 20 Ethical Foundations of Competence to Consent.
Страница 21
... desires or preferences . Some of these prefer- ences are for acquiring pleasure and averting pain , but other desires are equally important . The desire satisfaction theorist notes that peo- ple sometimes desire things that cause pain ...
... desires or preferences . Some of these prefer- ences are for acquiring pleasure and averting pain , but other desires are equally important . The desire satisfaction theorist notes that peo- ple sometimes desire things that cause pain ...
Страница 23
... desire ( regardless of whether our desires are for what is really good ) . Left without a list of what is universally good , people have to compose their own lists.10 That neither hedonists nor objective good theorists have been able to ...
... desire ( regardless of whether our desires are for what is really good ) . Left without a list of what is universally good , people have to compose their own lists.10 That neither hedonists nor objective good theorists have been able to ...
Страница 24
... desires . BENEFICENCE THROUGH AUTONOMY We determined in Section I that personal welfare was defined in terms of one's autonomously chosen value structure . We determined in Section II that actions that satisfy individuals ' desires are ...
... desires . BENEFICENCE THROUGH AUTONOMY We determined in Section I that personal welfare was defined in terms of one's autonomously chosen value structure . We determined in Section II that actions that satisfy individuals ' desires are ...
Страница 25
... desire . Having different desires helps to make people unique and forms the basis of particular value structures . Sometimes such disparities can be adjudicated by appealing to the patient's more powerful desires . It appears that the ...
... desire . Having different desires helps to make people unique and forms the basis of particular value structures . Sometimes such disparities can be adjudicated by appealing to the patient's more powerful desires . It appears that 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 |
| 24 | |
| 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 |
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Често срещани думи и фрази
able actions Adequately competent persons affective capacities Alzheimer's Disease appeals appeals to consequences assess auton autonomous choices Baruch Brody behavior bioethicists Buchanan and Brock choose clinicians cognitive and affective cognitive emotions cognitively capable compe competence to consent competent decision makers competent patients conception of competence consequence-dependent consequences consider deci decision-making authority decision-making process defining competence definition of competence degree determine diagnose discussion evaluate facts feelings felt and cognitive felt emotions first-order desires free and informed goals HCPs health care decisions hedonism hysterectomy identify important incompetent informed consent lives Marginally competent persons Mental Status Examination moral one's options outcomes particular petence placenta previa practice of informed preferences principle of respect professional promote question rational reason recognize recount refuse relevant information requires respect for autonomy risks second-order desires sions situations specific competence surgery task tence test for competence therapy threshold tion treatment understand value structures Virginia Abernethy welfare well-being
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Страница 28 - I am going to mean any coherent and complex form of socially established cooperative human activity through which goods internal to that form of activity are realized in the course of trying to achieve those standards of excellence which are appropriate to, and partially definitive of, that form of activity, with the result that human powers to achieve excellence, and human conceptions of the ends and goods involved, are systematically extended.
Страница 40 - It is better to be a human being dissatisfied, than a pig satisfied; better to be Socrates dissatisfied, than a fool satisfied.
Страница 13 - Act only on that maxim through which you can at the same time will that it should become a universal law...
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Страница 37 - Now I say: man and generally any rational being exists as an end in himself, not merely as a means to be arbitrarily used by this or that will...
Страница 153 - Reason is, and ought only to be, the slave of the passions, and can never pretend to any other office than to serve and obey them.
Страница 30 - A practice involves standards of excellence and obedience to rules as well as the achievement of goods. To enter into a practice is to accept the authority of those standards and the inadequacy of my own performance as judged by them. It is to subject my own attitudes, choices, preferences and tastes to the standards which currently and partially define the practice.
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