Subjects:

Mental Health Law

Contents:

1. Why Competence is Important: The Doctrine of Informed Consent

2. Thinking About Competence

3. Abilities Related to Competence

4. When Patients' Decision Making Should be Assessed

5. Assessing Patients' Capacities to Consent to Treatment

6. Using the MacArthur Competence Assessment Tool - Treatment

7. Making Judgements About Patients' Competence

8. Substitute Decision Making for Incompetent Patients

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 the decisions they might make, rests largely on clinicians' abilities to judge patients' capacities to decide what treatment they will receive.

Confusing laws and complex ethical questions surrounding competence to consent to treatment have made the process of competence assessment intimidating for many clinicians. Health professionals - physicians, medical students nad residents, nurses, and mental health practitioners - have long needed a consice guidebook that translates the issue for practice. This is what this book accomplishes.

The aurthors describe the place of competence in the doctrine of informed consent and show how assessments of competence to consent to treatment can be structured by using a specific set of general medical and psychiatric treatment settings, explain how the assessment should be conducted, and offer a structured interview method to assist the task. They also explore the often difficult process of making the judgement about competence and desire what to do when patients' capacities are limited.