Vollmann J
Lehrstuhl für Sozialmedizin, Sozialpsychiatrie und Medizinethik EV. Fachhochschule Berlin.
Psychiatr Prax. 1997 Jul;24(4):181-4.
To protect patients' autonomy, valid informed consent must be given prior to medical treatment. This includes disclosure of information, understanding, ability to decide freely, and competence/capacity of the patient. However, a psychiatric disorder may disturb the ability to make a choice of their own. These patients have lost their competence to give valid informed consent. In everyday practice of social psychiatry, it is of particular interest to have objective and valid criteria to identify the incompetent patient. These problems are discussed in a case report, and four criteria (understanding, reasoning, decision making and appreciation of the disorder) are presented to diagnose the patients' competence.
为保护患者的自主权，必须在医疗治疗前获得有效的知情同意。这包括信息披露、理解、自由决定的能力以及患者的行为能力。然而，精神疾病可能会干扰患者自主做出选择的能力。这些患者已丧失给出有效知情同意的行为能力。在社会精神病学的日常实践中，拥有客观有效的标准来识别无行为能力的患者尤为重要。本文通过一个病例报告讨论了这些问题，并提出了四个标准（理解、推理、决策和对疾病的认知）来诊断患者的行为能力。
