Roth L H, Meisel A, Lidz C W
Am J Psychiatry. 1977 Mar;134(3):279-84. doi: 10.1176/ajp.134.3.279.
The authors describe the various tests of competency to consent to treatment used today, which include the following: 1)evidencing a choice, 2)"reasonable" outcome of choice, 3)choice based on "rational" reasons, 4)ability to understand, and 5)actual understanding. They analyze the applicability of these tests to patients' decisions to accept or refuse psychiatric treatment and illustrate the problems of ap-lying these tests by citing clinical case examples. They find that the circumstances in which competency becomes an issue determine which elements of which tests are stressed and which are underplayed.
作者描述了当今用于判断治疗同意能力的各种测试,包括以下几点:1)表明有选择;2)选择的“合理”结果;3)基于“理性”理由的选择;4)理解能力;5)实际理解。他们分析了这些测试在患者接受或拒绝精神科治疗决策中的适用性,并通过引用临床案例来说明应用这些测试时存在的问题。他们发现,能力成为问题的具体情形决定了各项测试中哪些要素会得到强调,哪些会被忽视。