Clinical practice. Assessment of patients' competence to consent to treatment.
نویسنده
چکیده
Copyright © 2007 Massachusetts Medical Society. A 75-year-old woman with type 2 diabetes mellitus and peripheral vascular disease is admitted with a gangrenous ulcer of the plantar aspect of her left foot. A surgical consultation results in a recommendation for a below-the-knee amputation, but the patient declines the procedure on the grounds that she has lived long enough and wants to die with her body intact. Her internist, who has known her for 15 years, is concerned that she has been increasingly confused over the past year and now appears to be depressed. How should her physician determine whether her decision is a competent one?
منابع مشابه
Preliminary Turkish study of psychiatric in-patients' competence to make treatment decisions.
INTRODUCTION Competence is a prerequisite for informed consent. Patients who are found to be competent are entitled to accept or refuse the proposed treatment. In recent years, there has been an increased interest in studies examining competence for treatment in psychiatric patients. In this study, we aimed to investigate the decision-making competencies of inpatients with a range of psychiatri...
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BACKGROUND Currently over 50% of drugs prescribed to children have not been evaluated properly for use in their age group. One key reason why children have been excluded from clinical trials is that they are not considered able to exercise meaningful autonomy over the decision to participate. Dutch law states that competence to consent can be presumed present at the age of 12 and above; however...
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BACKGROUND The number of clinical trials including older patients, and particularly patients with cognitive impairment, is increasing. While statutory provisions exist to make sure that the capacity to consent is assessed systematically for each patient, many gray areas remain with regard to how this assessment is made or should be made in the routine practice of clinical research. OBJECTIVES...
متن کاملThe Greek version of the MacArthur competence assessment tool for treatment: reliability and validity. Evaluation of capacity for treatment decisions in Greek psychiatric patients
BACKGROUND Patients' informed consent prior to treatment initiation is an essential component of contemporary clinical practice, but sometimes, patients lack decision-making capacity for treatment. Such capacity can be reliably assessed with standardized tools used, and the MacArthur competence assessment tool for treatment (MacCAT-T) is one of the most widely used instruments. METHODS The ob...
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متن کاملMinors' capacity to refuse treatment: a reply to Gilmore and Herring.
Re R and Re W allow a parent to consent to treatment a competent minor refuses, but the cases have not been tested post-Human Rights Act 1998. Gilmore and Herring offer a means by which they might be distinguished or sidelined. They interpret Gillick to say that in order to consent a minor need only have a full understanding of the particular treatment. They argue that the minors in Re R and Re...
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ورودعنوان ژورنال:
- The New England journal of medicine
دوره 357 18 شماره
صفحات -
تاریخ انتشار 2007