评价能力:决定能力的额外标准
Lauren Harcarik1, Scott Y H Kim2, Joseph Millum3
1School of Social Work, University of Maryland, College Park, Maryland, USA.
Bioethics
|December 17, 2024
概括
这项研究提出了一种扩展的决策能力 (DMC) 模型,该模型包括与认知能力一起评估能力. 这种方法更好地尊重患者的自主权,因为它侧重于评估作为一种技能,而不仅仅是价值观的内容.
科学领域:
- 生物伦理学生物伦理学
- 思想的哲学 思想的哲学
- 医疗法 法律 医疗法
背景情况:
- 美国占主导地位的决策能力 (DMC) 模型依赖于四种认知能力:理解,欣赏,推理和沟通选择.
- 批评者认为,这种模式不足,忽视了情绪和价值观在自主决策中的作用.
- 目前关于将价值观纳入DMC的建议缺乏共识,并努力保护具有非传统价值观的患者.
研究的目的:
- 提出一个精细的决策能力模型,它整合了价值的能力.
- 为了解决以认知为中心的四种能力模型的局限性.
- 为了提供一个框架来尊重患者的自主权,即使与不寻常的价值观.
主要方法:
- 对自主决策所必需条件的概念分析.
- 开发一个新的概念的"价值能力"作为DMC的一个组成部分.
- 检查这种能力的组成部分,损伤指标和影响.
主要成果:
- 价值的能力被提出为DMC传统的四个能力的关键补充.
- 价值观的能力包括四个组成部分:拥有价值观,获得价值观,用价值观进行实际推理,并根据推理价值观采取行动.
- 这种扩展模型提供了更强大的容量计算,重点是估值过程.
结论:
- 一个全面的决策能力模型应该包括价值的能力.
- 专注于价值的能力,而不是价值的内容,更好地支持患者的自主权.
- 这一框架为评估和理解临床和伦理背景下的决策能力提供了新的视角.
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