Abernethy V
Am J Psychiatry. 1984 Jan;141(1):53-8. doi: 10.1176/ajp.141.1.53.
A competent patient has the right to refuse any medical intervention. However, hospitalized patients who refuse treatment sometimes find their competency challenged. The author describes the grounds for deciding that an elderly woman who resisted amputation "lacked capacity" to refuse the intervention, so that custody was conditionally awarded to a state social service department. Questions are raised about the evaluation process. The author suggests that the standard for finding a patient not competent to refuse treatment should be no less than generalized incompetence, including clear evidence that a patient is uninformable on emotionally neutral issues and cognitively incapable of making ordinary decisions on matters unrelated to the crisis at hand.
有行为能力的患者有权拒绝任何医疗干预。然而，拒绝治疗的住院患者有时会发现自己的行为能力受到质疑。作者描述了判定一名拒绝截肢的老年妇女“缺乏拒绝干预的能力”的依据，因此监护权被有条件地判给了一个州社会服务部门。文中对评估过程提出了质疑。作者建议，判定患者无能力拒绝治疗的标准不应低于普遍无行为能力，包括有明确证据表明患者在情绪中立的问题上无法接受信息，并且在与当前危机无关的事情上认知上无法做出普通决定。
