EVALUATION OF CAPACITY TO CONSENT TO TREATMENT AND RESEARCH doc

[...]... legal and social context of consent capacity assessments—its contours and history Because the assessment of consent capacity is highly context sensitive and requires considerable judgment, the evaluator must thoroughly grasp the basic legal and ethical principles to guide such an The Legal Context 5 assessment And this in turn requires an understanding of the history and purpose of the doctrine of informed... informed consent, doctors and patients did talk to each other and consent was legally required and generally obtained SIMPLE CONSENT This practice of consent during the pre-informed consent era has been called ‘‘simple consent ’ (Grisso & Appelbaum, 1998) In both simple and informed consent, it is expected that doctors would disclose something to patients about their medical situation and obtain their consent. .. forensic assessments and the assessment of capacity for treatment consent, and this difference has important practical implications for the evaluator To appreciate the difference, compare the evaluation of treatment consent capacity with the evaluation of a criminal defendant’s competence to stand trial The latter evaluation arises because a person is in court (on a criminal charge), and it involves interests... Purpose and History of Capacity to Consent to Treatment Patients provide valid informed consent to a treatment or a diagnostic procedure if they have sufficient capacity, have been given appropriate information, and give consent freely without coercion or undue influence When a patient’s capacity for treatment consent is in doubt, a clinician must determine whether the patient indeed has the capacity. .. an unwanted touching During the preinformed consent era, the doctor determined what was good for the patients to know, even if it meant deceiving them (Faden & Beauchamp, 1986) In fact, it is this welfare-based (rather than autonomy-based) model of the doctor–patient relationship that dictated the content of disclosures (of risks and benefits of a proposed treatment) that doctors provided to patients... informed consent until 1981 (Faden & Beauchamp, 1986) This does not mean that doctors forcibly imposed operations (the literature and law on consent is often a story about surgical treatments) on patients without their knowledge and consent prior to that period The practice of obtaining the consent of the patient for surgical procedures is as old as medicine Often cited is Slater v Baker and Stapleton (1767),... natural use of the term that can be easily inferred from its context of use As this is a book about treatment consent capacity, the unqualified uses of terms capacity, decision making capacity, and compe tence are all meant to refer to that capacity Thus, capacity and competence will be used interchangeably When a court’s determination of capacity is specifically meant, it will be referred to as ‘‘adjudicated... interpreted and incorporated into the practice of capacity evaluations in two parts First, it turns to the topic of standards or definitions of capacity that legally define the concept, and provides a framework for interpreting and implementing them in a way that is consistent with law and is clinically useful Second, the chapter discusses what might be called the pillars of the modern concept of capacity. .. understand the information that is disclosed in informed consent discussions is perhaps the most intuitive standard, and indeed some version of it is present in all discussions of competency standards and in all legal definitions of capacity (Berg et al., 1996) The ability to understand is broader than a mere retention and regurgitation of what the doctor tells the patient The patient must be able to ‘‘grasp... elements of the decision-making situation that a doctor must disclose to the patient It became necessary for doctors to disclose the nature of the condition and its proposed treatment, its risks and benefits, and the alternatives to treatment and their potential outcomes, including the option of not treating at all (Natanson v Kline, 1960) This list of course has a familiar ring because it has largely . Connell, and Kathryn Kuehnle Evaluation for Disposition and Transfer of Juvenile Offenders, Randall T. Salekin EVALUATION OF CAPACITY TO CONSENT TO TREATMENT AND RESEARCH SCOTT Y. H. KIM 1 2010 1 Oxford. in turn requires an understanding of the history and purpose of the doctrine of informed consent. Legal History of Informed Consent The legal doctrine of informed consent is about 30–50 years. Cutler and Margaret Bull Kovera Civil Titles Evaluation of Capacity to Consent to Treatment and Research, Scott Y. H. Kim Evaluation for Guardianship, Eric Y. Drogin and Curtis L. Barrett Evaluation