Pepper-Smith R, Harvey W R, Silberfeld M
Department of Classics, Philosophy and Religion, Malaspina University-College, Nanaimo, British Columbia, Canada.
Theor Med. 1996 Jun;17(2):135-50. doi: 10.1007/BF00539736.
At least four different frameworks--psychiatric, cognitive, functional and decision-making--are used in the evaluation of competence, all of which remain more or less unrelated in the literature. In the first section of this paper we consider various meanings of "competence," in order to arrive at a definition of the term relevant to the medical and legal setting. Patient or client "competence," we conclude, refers to the practical abilities that individuals employ in pursuing their own autonomous goals in life. We then show how a systematic categorization of these practical abilities--which we call a taxonomy of practical judgment--allows us to show when the traditional frameworks for the evaluation of competence may or may not be useful in the evaluation of a particular competence. In the final section we explore some of the normative considerations underlying the taxonomy. For instance, competence is not only related to intrinsic abilities but to resources available in the community. Here we touch on questions related to the fair distribution of community resources.
在能力评估中至少使用了四种不同的框架——精神病学框架、认知框架、功能框架和决策框架，在文献中所有这些框架或多或少都是相互独立的。在本文的第一部分，我们探讨了“能力”的各种含义，以便得出一个与医学和法律背景相关的术语定义。我们得出结论，患者或客户的“能力”是指个人在追求自己生活中的自主目标时所运用的实际能力。然后我们展示了如何对这些实际能力进行系统分类——我们称之为实际判断分类法——使我们能够表明，传统的能力评估框架在评估特定能力时何时可能有用或无用。在最后一部分，我们探讨了分类法背后的一些规范性考量。例如，能力不仅与内在能力有关，还与社区中可用的资源有关。在此我们涉及到与社区资源公平分配相关的问题。
