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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... require further investigation . Nevertheless , since health care interventions have the potential to alter patients ' lives in momentous ways , whether or not a patient is competent should not be left to " gut - level " feelings . Some ...
... requires . For exam- ple , cardiovascular surgeons are competent if they have ( among others ) the capacities to diagnose surgically correctable cardiovascu- lar pathology , perform operative procedures that remedy these disor- ders ...
... requires that persons giving consent be competent . Valid consents depend on knowing when patients are and are not competent . WHEN COMPETENCE IS IN QUESTION Even if most patients are competent , some are not . Numerous con- ditions ...
... requires that autonomy be respected . But what does it mean to respect auton- omy ? Practically speaking , what must one do ? First , because " auton- omy " refers to making choices in concert with one's value structure , respecting ...
... requires freedom from inhi- bitions that impede decision - making ability and authority . Inhibitions can be internal ( e.g. , fear , pain , altered mental status ) or external ( e.g. , pressure from family , friends , or HCPs to choose ...
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 |