Siegel Andrew M, Barnwell Anna S, Sisti Dominic A
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Second Floor, Philadelphia, PA, 19104, USA,
HEC Forum. 2014 Jun;26(2):159-68. doi: 10.1007/s10730-014-9234-8.
Decision making capacity (DMC) is a fundamental concept grounding the principle of respect for autonomy and the practice of obtaining informed consent. DMC must be determined and documented every time a patient undergoes a hospital procedure and for routine care when there is reason to believe decision making ability is compromised. In this paper we explore a path toward ethically informed development and implementation of a hospital policy related to DMC assessment. We begin with a review of the context of DMC assessment before discussing some considerations relevant to policy creation by healthcare ethics committees. The discussion concludes in a presentation of a typology of capacity assessment policies, which draws upon a sampling of currently used hospital policies to illustrate relevant ethical considerations.
决策能力（DMC）是尊重自主权原则和获取知情同意实践的一个基本概念。每当患者接受医院程序以及在有理由相信决策能力受损时进行常规护理时，都必须确定并记录决策能力。在本文中，我们探索了一条在伦理上明智地制定和实施与决策能力评估相关的医院政策的途径。我们首先回顾决策能力评估的背景，然后讨论与医疗伦理委员会制定政策相关的一些考虑因素。讨论最后呈现了能力评估政策的类型学，该类型学借鉴了当前使用的医院政策样本来说明相关的伦理考量。
