Kaplan K H, Strang J P, Ahmed I
Department of Psychiatry, Boston University School of Medicine, MA.
Gen Hosp Psychiatry. 1988 Nov;10(6):385-8. doi: 10.1016/0163-8343(88)90060-6.
The psychiatric literature on competency indicates that a diagnosable psychiatric condition alone does not imply incompetency to make treatment decisions. Nonetheless, it is frequently assumed that individuals who are either mentally retarded or demented are incompetent to make decisions. The authors, focusing on the clinical assessment of judgment and decision making, describe two cases. In both, the patients' judgments were intact. The authors conclude: (1) Diagnosis is not the critical factor in determining competency. (2) The process of judgment and decision making has to be assessed on a case by case basis. (3) Further research is needed to develop clinical instruments to assess judgment.
精神病学文献中关于行为能力的内容表明，仅患有可诊断的精神疾病并不意味着没有做出治疗决策的行为能力。然而，人们常常认为，智力迟钝或患有痴呆症的个体没有决策能力。作者聚焦于判断力和决策能力的临床评估，描述了两个案例。在这两个案例中，患者的判断力都是完好的。作者得出结论：（1）诊断并非决定行为能力的关键因素。（2）判断力和决策能力的评估过程必须逐案进行。（3）需要开展进一步研究以开发评估判断力的临床工具。
