The Psychology of Competence and Informed Consent: Understanding Decision-Making with Regard to Clinical Research

This Article examines the importance of patient autonomy and competence in medical decision making and how questions of competence affect informed consent. The author explores three hypothetical cases which “outline the parameters of ‘competence’ by illustrating the methodologies used in making [determinations of competence], distinguishing between ethical and legal issues in the assessment of competence, and reviewing the procedures for surrogate decision making when competence is deemed impaired.” The cases present questions on when to respect patient autonomy and when it may be appropriate to allow a surrogate to take over decision making.