Assessing Patients' Capacities to Consent to Treatment
Appelbaum, Paul S.
New England Journal of Medicine. 1988 Dec 22; 319(25): 1635-1638.
Current legal concepts and standards of competence to consent to medical treatment are reviewed. The four related skills of communicating choices, understanding relevant information, appreciating the current situation and its consequences, and manipulating information rationally must be determined when a patient's decision-making capacity is called into question. The clinical examiner's proper role is to gather relevant information and to decide whether an adjudication of incompetence is required. In an emergency situation, the presumption of competence remains, but life-threatening circumstances lower the threshold at which a determination of incompetence is made. (KIE abstract)
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