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Cognitive functions in the informed consent evaluation process: a pilot study

J C Holzer1, D A Gansler, N P Moczynski

  • 1Tufts School of Medicine, Department of Psychiatry, New England Medical Center, Boston, MA, USA. jholzer@opal.tufts.edu

The Journal of the American Academy of Psychiatry and the Law
|January 1, 1997
PubMed
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Assessing patient capacity for informed consent can be strengthened by evaluating cognitive functions. Executive cognitive functions, particularly via the Executive Interview, showed the best accuracy in determining competency.

Area of Science:

  • Neuroscience
  • Medical Ethics
  • Cognitive Psychology

Background:

  • Informed consent capacity assessment in hospitals relies on subjective clinical judgment.
  • This process is limited by subjectivity, variability between examiners, and a lack of quantitative tools.
  • Identifying associated variables can improve the accuracy of competency assessments.

Purpose of the Study:

  • To investigate the association between cognitive functions and the capacity to give informed consent.
  • To determine if cognitive measures can enhance the assessment of patient competency.

Main Methods:

  • Evaluated 65 general hospital inpatients (medical and neurology) for informed consent capacity.
  • Administered tests including the Hopkins Competency Assessment Test, Mini-Mental Status Examination, Trail-Making Test (A & B), and Executive Interview.
Keywords:
Empirical ApproachLemuel Shattuck Hospital (Boston, MA)Professional Patient Relationship

Related Experiment Videos

  • Classified patients into "competent" and "noncompetent" groups based on clinical evaluation.

    • Main Results:

    • Significant differences were found between competent and noncompetent groups in general mental state, attentional, and executive cognitive functions.
    • The Executive Interview demonstrated the highest sensitivity and specificity in correctly classifying patient competency.
    • Age and education levels did not significantly differ between the competent and noncompetent groups.

    Conclusions:

    • Cognitive function measures are associated with the capacity to give informed consent in a hospital setting.
    • Utilizing cognitive function assessments, especially executive function measures, can strengthen the competency evaluation process.
    • Objective cognitive assessments offer a more robust approach to determining patient capacity for informed consent.