Bursztajn H J, Harding H P, Gutheil T G, Brodsky A
Program in Psychiatry and the Law, Mass. Mental Health Center.
Bull Am Acad Psychiatry Law. 1991;19(4):383-8.
Most of the criteria for competence in current use emphasize cognitive rather than affective dimensions. Our clinical experience indicates that affective disorders may impair competence in a detectable and identifiable way. In particular, patients with major affective disorders can retain the cognitive capacity to understand the risks and benefits of a medication, yet fail to appreciate its benefits. A case study of a pathologic grief reaction is introduced to illustrate how cognitive and affective impairments may coexist and require separate remedial strategies for restoration. Further empirical work on the role of affective disorder in impairing competence is warranted and planned.
当前使用的大多数能力标准都强调认知维度而非情感维度。我们的临床经验表明，情感障碍可能以可检测和可识别的方式损害能力。特别是，患有重度情感障碍的患者可能保留理解药物风险和益处的认知能力，但却无法认识到其益处。本文引入了一个病理性悲伤反应的案例研究，以说明认知和情感障碍可能如何共存，以及需要不同的补救策略来恢复能力。关于情感障碍在损害能力方面作用的进一步实证研究是必要的且已在计划之中。
