Assessing Competence to Consent to Treatment: A Guide for Physicians and Other Health Professionals

Hardcover | January 1, 1998

byThomas Grisso, Paul S. Appelbaum

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One of the most challenging tasks facing clinicians today is the assessment of patients' capacities to consent to treatment. The protection of a patient's right to decide, as well as the protection of incompetent patients from the potential harm of their decisions, rests largely on clinicians'abilities to judge patients' capacities to decide what treatment they will receive. However, confusing laws and the complicated ethical issues surrounding the concept of competence to consent have made the process of competence assessment intimidating for many clinicians. Healthprofessionals--physicians, medical students, residents, nurses, and mental health practitioners--have long needed a concise guidebook that translates the issues for practice. That is what this book accomplishes. This volume is the product of an eight-year study of patients' capacities to make treatment decisions--the most comprehensive research of its kind. The authors describe the place of competence in the doctrine of informed consent, analyze the elements of decision-making, and show how assessments ofcompetence to consent to treatment can be conducted within varied general medical and psychiatric treatment settings. The book explains how assessments should be conducted and offers detailed, practice-tested interview guidelines to assist medical practitioners in this task. Numerous case studiesillustrate real-life applications of the concepts and methods discussed. Grisso and Appelbaum also explore the often difficult process of making judgments about competence and describe what to do when patients' capacities are limited. A timely, practical handbook relevant to every medical specialty, Assessing Competence to Consent to Treatment will benefit a wide array of medical practitioners--including physicians, medical students, residents, nurses, and other allied health professionals--who need to assess the mentalcompetence of patients in their everyday practice. It will also interest ethicists and moral philosophers, as well as geriatricians and clinical psychologists working with cognitively impaired patients.

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From the Publisher

One of the most challenging tasks facing clinicians today is the assessment of patients' capacities to consent to treatment. The protection of a patient's right to decide, as well as the protection of incompetent patients from the potential harm of their decisions, rests largely on clinicians'abilities to judge patients' capacities to ...

Thomas Grisso, Ph.D. is Professor of Psychiatry and Director of Forensic Training and Research at the University of Massachusetts Medical Center. Paul S. Appelbaum, M.D., is the A.F. Zeleznik Professor of Psychiatry, and Chairman of the Department of Psychiatry at the University of Massachusetts Medical Center. His books include: Tra...

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Format:HardcoverDimensions:224 pages, 5.39 × 8.31 × 0.98 inPublished:January 1, 1998Publisher:Oxford University Press

The following ISBNs are associated with this title:

ISBN - 10:0195103726

ISBN - 13:9780195103724

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Table of Contents

1. Why Competence is Important: The Doctrine of Informed Consent2. Thinking About Competence3. Abilities Related to Competence4. When Patients' Decision Making Should be Assessed5. Assessing Patients' Capacities to Consent to Treatment6. Using the MacArthur Competence Assessment Tool - Treatment7. Making Judgements About Patients' Competence8. Substitute Decision Making for Incompetent Patients

Editorial Reviews

"Grisso and Appelbaum have given us a complete and concise description of the law, theoretical considerations, and an operational model for determining competency to consent to treatment . . . . This work is truly a guide for the assessment of competence to consent to treatment. Anyone whodevelops an understanding of what is written here will be competent to determine this type of competency. Even those who think they know how to do it can benefit from reading this book. It's like a brief refresher course and highly recommended." The Journal of Nervous and Mental Disease