Moberg Paul J, Kniele Kathryn
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
Appl Neuropsychol. 2006;13(2):101-14. doi: 10.1207/s15324826an1302_5.
The assessment of decision-making capacity is an essential element of competency determinations. As experts in the assessment of human cognitive abilities, neuropsychologists may be the best adjudicators of competency. However, to maximize the contribution of neuropsychology to the courts in the determination of competency, clinicians must be aware of the professional controversies and ethical challenges inherent in the assessment of decision-making capacity and the determination of competence. Professional controversies include the lack of established methodological and procedural guidelines for capacity evaluations and the application of variable criteria to establish impairment. Ethical challenges include balancing the need to respect the individual's freedom of choice and self-determination with the need to promote the individual's safety; attaining professional competence; and selecting, using, and interpreting assessment methods appropriately. The purpose of this article is to examine these issues in the context of neuropsychological practice.
决策能力评估是能力判定的一个基本要素。作为人类认知能力评估方面的专家，神经心理学家可能是能力判定的最佳裁决者。然而，为了在能力判定中使神经心理学对法庭的贡献最大化，临床医生必须意识到在决策能力评估和能力判定中固有的专业争议和伦理挑战。专业争议包括缺乏既定的能力评估方法和程序指南，以及应用可变标准来确定损伤。伦理挑战包括在尊重个人选择自由和自我决定权的需求与促进个人安全的需求之间取得平衡；获得专业能力；以及适当地选择、使用和解释评估方法。本文的目的是在神经心理学实践的背景下审视这些问题。
