How to determine competency

Journal of Clinical Ethics

Volumn 12, Issue 1, 2001, Pages 3-16

  Howe, Edmund G ^a  

^a UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADDICTION; ANOREXIA NERVOSA; ARTICLE; CLASSIFICATION; DECISION MAKING; DEMENTIA; DENIAL; DOCTOR PATIENT RELATION; HEALTH CARE QUALITY; HUMAN; LEGAL ASPECT; MENTAL CAPACITY; PATIENT; PRIMARY HEALTH CARE; PROFESSIONAL PATIENT RELATIONSHIP; PSYCHIATRY; PSYCHOLOGICAL ASPECT; UNITED STATES;

PROFESSIONAL PATIENT RELATIONSHIP;

ANOREXIA NERVOSA; DECISION MAKING; DEMENTIA; DENIAL (PSYCHOLOGY); HUMANS; MENTAL COMPETENCY; PATIENTS; PHYSICIAN-PATIENT RELATIONS; PRIMARY HEALTH CARE; PROCESS ASSESSMENT (HEALTH CARE); PSYCHIATRY; SUBSTANCE-RELATED DISORDERS; UNITED STATES;

EID: 0035291105     PISSN: 10467890     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (3)

1. As Gutheil and Appelbaum state, "Statutes and court decisions have done little to move beyond the vagueest descriptions of what constitutes general competence. . . . It seems . . . that the tendency has been to give the judiciary maximal flexibility in determining that an individual is incompetent." T.G. Gutheil and P.S. Appelbaum, Clinical Handbook of Psychiatry and the Law, 3rd ed. (Philadelphia: Lippincott Williams & Wilkins, 2000), 221. These authors also state in regard to "specific" competency, or competency "more focused" on a particular issue, such as choosing one's medical care, "each court tends to . . . derive standards de novo," and this "compounds the confusion" (p. 222).
2. Some persons criticize those who seek a competency evaluation when a patient refuses treatment, but not when the patient accepts it. This practice has, however, a sound rationale. The relative difference in the out-comes in both these situations is great. Thus, this different treatment may be justifiable on the same basis as using a sliding scale.
3. M.S. Gazzaniga, The Mind's Past (Berkeley, Calif.: University of California Press, 1998), pp. 41 and 1.