Criteria for patient decision making (in)competence: A review of and commentary on some empirical approaches [Book Review]
David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Ezio Di Nucci
Jack Alan Reynolds
Learn more about PhilPapers
Medicine, Health Care and Philosophy 4 (2):139-151 (2001)
The principle of autonomy presupposes Patient Decision Making Competence (PDMC). For a few decades a considerable amount of empirical research has been done into PDMC. In this contribution that research is explored. After a short exposition on four qualities involved in PDMC, different approaches to assess PDMC are distinguished, namely a negative and a positive one. In the negative approach the focus is on identifying psychopathologic conditions that impair sound decision making; the positive one attempts to assess whether a patient actually has the required abilities and qualities. Characteristic of the latter approach is the use of (or development of) test-like instruments for PDMC assessment. Some of these tests are discussed and commented on. Although they may be useful in investigating aspects of PDMC, none of the described approaches and tests offers a reliable and valid method for PDMC assessment. In response to a potential misuse of tests, the concept of a supportive situation is briefly introduced in order to draw attention to the risk of prematurely deeming patients incompetent on the basis of low test scores, whereas their insufficient performance may be (partly) attributable to alack of situational support. Also, the need for and possibility of an emotionalist concept of PDMC are suggested, as an alternative to the more common rationalist one. In this regard,the legitimacy of competence being conceived as a presumption or fiction of law, deserves further investigation
|Keywords||emotional competence empirical criteria incompetence legal fiction of competence psychology supportive situation tests|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
Torsten Marcus Breden & Jochen Vollmann (2004). The Cognitive Based Approach of Capacity Assessment in Psychiatry: A Philosophical Critique of the MacCAT-T. [REVIEW] Health Care Analysis 12 (4):273-283.
Orsolya Friedrich (2013). Knowledge of Partial Awareness in Disorders of Consciousness: Implications for Ethical Evaluations? Neuroethics 6 (1):13-23.
Fabrice Jotterand, Shawn M. McClintock, Archie A. Alexander & Mustafa M. Husain (2010). Ethics and Informed Consent of Vagus Nerve Stimulation (VNS) for Patients with Treatment-Resistant Depression (TRD). Neuroethics 3 (1):13-22.
Demian Whiting (2015). Evaluating Medico-Legal Decisional Competency Criteria. Health Care Analysis 23 (2):181-196.
Ron Berghmans, Donna Dickenson & Ruud Ter Meulen (2004). Editorial: Mental Capacity: In Search of Alternative Perspectives. Health Care Analysis 12 (4):251-263.
Similar books and articles
Jos V. M. Welie & Sander P. K. Welie (2001). Patient Decision Making Competence: Outlines of a Conceptual Analysis. [REVIEW] Medicine, Health Care and Philosophy 4 (2):127-138.
Kristine Bærøe (2010). Patient Autonomy, Assessment of Competence and Surrogate Decision-Making: A Call for Reasonableness in Deciding for Others. Bioethics 24 (2):87-95.
Jillian Craigie (2011). Competence, Practical Rationality and What a Patient Values. Bioethics 25 (6):326-333.
Roy Gilbar & Ora Gilbar (2009). The Medical Decision-Making Process and the Family: The Case of Breast Cancer Patients and Their Husbands. Bioethics 23 (3):183-192.
Lars Sandman & Christian Munthe (2009). Shared Decision-Making and Patient Autonomy. Theoretical Medicine and Bioethics 30 (4):289-310.
Steve Clarke (2013). The Neuroscience of Decision Making and Our Standards for Assessing Competence to Consent. Neuroethics 6 (1):189-196.
Wim J. M. Dekkers (2001). Autonomy and Dependence: Chronic Physical Illness and Decision-Making Capacity. Medicine, Health Care and Philosophy 4 (2):185-192.
Mats Johansson & Linus Broström (2008). Turning Failures Into Successes: A Methodological Shortcoming in Empirical Research on Surrogate Accuracy. Theoretical Medicine and Bioethics 29 (1):17-26.
Floris Tomasini (2010). A Broader Notion of Competent Decision Making in Respect to What Is in the Best Interests of Patients Affected by Anorexia. Philosophy, Psychiatry, and Psychology 17 (2):155-157.
Lorraine Y. Landry (1999). Multi-Disciplinary Competence Assessment: A Case Study in Consensus and Culture. Theoretical Medicine and Bioethics 20 (5):423-437.
Kristine Baerøe (2010). Patient Autonomy, Assessment of Competence and Surrogate Decision-Making: A Call for Reasonableness in Deciding for Others. Bioethics 24 (2):87-95.
Stephen G. Pauker (1984). Decision Analysis as a Basis for Medical Decision Making: The Tree of Hippocrates. Journal of Medicine and Philosophy 9 (2):181-214.
Eric Vogelstein (2014). Competence and Ability. Bioethics 28 (5):235-244.
Ajit Shah (2011). Mental Competence or Best Interests? Philosophy, Psychiatry, and Psychology 18 (2):151-152.
Lars Sandman, Bradi B. Granger, Inger Ekman & Christian Munthe (2011). Adherence, Shared Decision-Making and Patient Autonomy. Medicine, Health Care and Philosophy 15 (2):115-127.
Added to index2010-08-31
Total downloads13 ( #272,153 of 1,906,981 )
Recent downloads (6 months)1 ( #468,378 of 1,906,981 )
How can I increase my downloads?