Multi-disciplinary competence assessment: a case study in consensus and culture

The case of May Redwing, an American Indian woman assessed for competence is examined in detail. The case highlights the interconnections between the cultures of medicine and law and notes the importance of criteria of competence assessment, but also underscores the necessity of attention to the patient's cultural background in a multi-disciplinary competence assessment team process. Three interrelated areas of inquiry are explored: (1) Can we expect a morally and politically justifiable assessment of competence from a multi-disciplinary approach? (2) What pitfalls threaten a multi-disciplinary approach? and (3) How are the patient's cultural background and values relevant to a proper assessment of competence? These questions are investigated in the context of analyzing and evaluating a particularly difficult case. Although focused on a specific case, the study is instructive and cautionary for any group undertaking the challenges of multi-disciplinary competence assessment.