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Patient decision making competence: outlines of a conceptual analysis
1Center for Health Policy and Ethics, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA. jwelie@creighton.edu
Medicine, Health Care, and Philosophy
|September 8, 2001
Summary
Patient autonomy is protected by informed consent, but requires decision-making competence. This study defines competence and its conditions, addressing the lack of clear definitions and reliable diagnostic methods for patient incompetence.
Area of Science:
- Bioethics
- Medical Law
- Clinical Psychology
Background:
- Patient autonomy is a fundamental right, primarily exercised through informed consent.
- Competence is essential for a patient to exercise autonomy and make healthcare decisions.
- Current definitions and diagnostic methods for patient decision-making competence lack consensus and reliability.
Purpose of the Study:
- To address the ambiguity surrounding patient decision-making competence.
- To establish a clear, generic definition of competence.
- To derive necessary conditions for competence and apply them to healthcare.
Main Methods:
- Conceptual analysis of the term 'competence'.
- Derivation of four necessary conditions for competence.
- Application of the derived definition and conditions to patient decision-making in healthcare.
Main Results:
- A generic definition of competence is proposed.
- Four essential conditions for competence have been identified.
- The definition and conditions are transposed to the healthcare context, focusing on patient decision-making.
Conclusions:
- A precise definition and diagnostic criteria for patient competence are crucial for upholding patient autonomy.
- The proposed framework aims to improve the reliable assessment of patient decision-making competence.
- Clarifying competence is vital to prevent unwarranted limitations on patient rights.
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