当患者有可预见的失去决策和功能能力的风险时
Matthew Robert Dernbach1, Peter Ash2, Esther Oyerinde2
1Dr. Dernbach is a Medical Toxicology Fellow, Department of Emergency Medicine; Dr. Ash is a Professor and Director, Psychiatry and Law Service, Department of Psychiatry and Behavioral Sciences; and Ms. Oyerinde is a Medical Student, Emory University, Atlanta, GA. Dr. Oldham is an Associate Professor of Psychiatry, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY. matthew.robert.dernbach@emory.edu.
患者可能目前具有决策能力,但由于不遵守,未来可能面临失能. 这项研究引入了"失去能力的可预见风险",以解决医疗治疗同意的差距.
科学领域:
- 医学伦理 医学伦理
- 神经科学是一个神经科学.
- 法律医学 法律医学
背景情况:
- 决策能力的四个技能模型是知情同意的标准.
- 目前的评估集中在一个时间点.
- 经常出现的不遵守行为会造成未来失能的风险.
研究的目的:
- 解决评估经常出现精神状态变化和不坚持患者的差距.
- 引入了"失去决策和功能能力的可预见风险"的概念.
- 讨论临床评估及其对能力确定的影响.
主要方法:
- 文献综述和概念分析.
- 识别一种新的风险因素.
- 讨论临床情景和干预措施.
主要成果:
- 提出了一个新的风险因素,即"失去决策和功能能力的可预见风险".
- 概述了风险患者的临床评估策略.
- 考虑了确定当前容量的影响.
结论:
- 可预见的风险是评估非坚持患者的决策能力的关键因素.
- 需要采取干预措施来保护患者的权利和安全.
- 适应能力评估模型对于复杂的临床情况是必要的.
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