实用主义者的决策能力评估指南。
A pragmatist's guide to the assessment of decision-making capacity.
机构信息
Lecturer, Department of Psychiatry,Yale School of Medicine,USA.
Assistant Professor,Department of Medical Ethics and Health Policy,University of Pennsylvania; andDirector of the Scattergood Program for Applied Ethics of Behavioral Health Care,Perelman School of Medicine,University of Pennsylvania,USA.
出版信息
Br J Psychiatry. 2019 Apr;214(4):183-185. doi: 10.1192/bjp.2019.17.
Abstract
Choice, understanding, appreciation and reasoning compose the standard model of decision-making capacity. Difficulties in determining capacity can arise when patients exhibit partial impairment. We suggest that a pragmatic approach, focusing on how capacity status affects the ultimate decision to override the patient's wishes, can help evaluators resolve difficult cases.Declaration of interestNone.
摘要
选择、理解、欣赏和推理构成了决策能力的标准模型。当患者表现出部分受损时，确定能力可能会遇到困难。我们建议采取一种实用的方法，重点关注能力状况如何影响最终决定是否推翻患者的意愿，这可以帮助评估者解决困难病例。
利益声明
无。
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2
Capable of more: some underemphasized aspects of capacity assessment.还有更多能力：能力评估中一些未被充分重视的方面。
Psychosomatics. 2015 May-Jun;56(3):217-26. doi: 10.1016/j.psym.2014.11.004. Epub 2014 Nov 21.
3
Clinical practice. Assessment of patients' competence to consent to treatment.临床实践。评估患者对治疗的同意能力。
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