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

Sadoff, Robert L.

doi:10.1176/ps.50.3.425

Cited by 12 publications

(18 citation statements)

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“…This is not to say that people with eating disorders are ideally rational. The important question for the issue of decisional competence, however, is whether they suffer from severe breakdowns in their rational capacity (Grisso & Appelbaum, 1998). My account suggests that they do not.…”

Section: Discussionmentioning

confidence: 99%

“…This is in cases where individuals are incompetent to make decisions regarding their own treatment. One necessary condition for decisional competence (in most European and North American legal contexts) is the ability to reason (Grisso & Appelbaum, 1998). While there is some ambiguity over what forms of basic reasoning abilities are required (Hawkins & Charland, 2020), they are often specified as those that facilitate understanding and appreciation of the relevant medical facts (Matthews, 2000, p. 63).…”

Section: The Implications Of Epistemic Irrationalitymentioning

confidence: 99%

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The rationality of eating disorders

Gadsby

2022

Mind & Language

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Sufferers of eating disorders often hold false beliefs about their own body size. Such beliefs appear to violate norms of rationality, being neither grounded by nor responsive to appropriate forms of evidence. I defend the rationality of these beliefs. I argue that they are in fact supported by appropriate evidence, emanating from proprioceptive misperception of bodily boundaries. This argument has far-reaching implications for the explanation and treatment of eating disorders, as well as debates over the relationship between rationality and human psychology.

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Section: Discussionmentioning

confidence: 99%

Section: The Implications Of Epistemic Irrationalitymentioning

confidence: 99%

The rationality of eating disorders

Gadsby

2022

Mind & Language

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“…Clinical tests for capacity provide no cutoff score for the determination of incapacity. 26 Rather, patient performance is weighed against the clinical circumstances, context, and stakes of the decision. For instance, as a decision's risk of harm increases, it is widely held that there is a progressively higher bar for decisional ability.…”

Section: Supporting Supported Decision Makingmentioning

confidence: 99%

Supported decision making: Facilitating the self‐determination of persons living with Alzheimer's and related diseases

Largent,

Peterson,

Karlawish

2023

J American Geriatrics Society

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Decision‐making capacity describes the ability to make a particular decision at a given time. People with Mild Cognitive Impairment (MCI) and mild stage dementia typically experience an associated erosion of their decisional abilities. Many could be said to have marginal capacity. These individuals are in a liminal space between adequate and inadequate capacity. Too often, marginal capacity is overlooked as a category: individuals are classified either as having capacity and being able to make decisions independently or as lacking capacity and needing a surrogate to make decisions for them. These approaches can, respectively, result in under‐ or overprotection of individuals with marginal capacity. A promising alternative approach is supported decision making. In supported decision making, a person with marginal capacity identifies a trusted person or network of persons to aid them in making their own decisions. Supported decision making is recognized by law in a growing number of states; it is important for geriatricians to be familiar with the concept, as they are increasingly likely to encounter it in their practice. Even in states where supported decision making is not formally recognized, it can be practiced informally, helping patients, care partners, and clinicians strike an appropriate balance between respecting autonomy and recognizing vulnerability. In this article, we describe supported decision making, discuss its ethical and legal foundations, and identify steps by which geriatricians can incorporate it into their practice.

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“…The Decision-Making Model of FC is based on the Appelbaum and Grisso decisional capacity concepts. 122 In the Person-Centered Model of FC, the influence of exploitative, abusive, or unduly influential relationships on financial decision-making is considered. 123 ; The Institute of Medicine's Model of FC sees FC as the ability to function with financial decision-making in the real world, based on the Social Security Administration's approach to determining financial capability.…”

Section: Medicolegal Implications Of Mindmentioning

confidence: 99%

Medicolegal Implications of Mild Neurocognitive Disorder

Bejenaru

Ellison

2020

J Geriatr Psychiatry Neurol

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Introduction: The syndromes of mild cognitive impairment (MCI) or mild neurocognitive disorder (MiND), often prodromal to dementia (Major Neurocognitive Disorder), are characterized by acquired clinically significant changes in one or more cognitive domains despite preserved independence. Mild impairment has significant medicolegal consequences for an affected person and their care system. We review the more common etiologies of MiND and provide a systematic review of its medicolegal implications. Methods: We conducted a systematic review of the peer-reviewed English literature on medicolegal aspects of MCI or MiND using comprehensive search terms and expanding our review to include sources cited by these reports. Results: Impairment of memory, executive function, social cognition, judgment, insight or abstraction can alter an individual’s abilities in a variety of areas that include decision making, informed consent, designation of a surrogate decision-maker such as a health care proxy, understanding and management of financial affairs, execution of a will, or safe driving. Conclusion: Even mild cognitive impairment can have significant behavioral consequences. Clinicians can assist care partners and persons with MCI or MiND by alerting them to the medicolegal concerns that often accompany cognitive decline. Early recognition and discussion can help a care system manage medicolegal risk more effectively and promote thoughtful advance planning.

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

Cited by 12 publications

References 0 publications

The rationality of eating disorders

The rationality of eating disorders

Supported decision making: Facilitating the self‐determination of persons living with Alzheimer's and related diseases

Medicolegal Implications of Mild Neurocognitive Disorder

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