Document Detail

When patients refuse assessment of decision-making capacity: how should clinicians respond?
MedLine Citation:
PMID:  15364668     Owner:  NLM     Status:  MEDLINE    
When patients refuse beneficial treatment, the assessment of decision-making capacity plays a key role in determining the best course of action. However, situations in which patients refuse to explain their reasons occur. This can make an assessment of capacity impossible. In such cases, clinicians find themselves in difficult situations without clear ethical guidance. Refusal to give reasons for refusing beneficial treatment has been seen as pointing to the absence of decision-making capacity. However, the reasons given for this are either unsatisfactory or insufficient to eliminate cases of genuine uncertainty. This article argues that although it cannot be concluded that such patients are incompetent, there are reasons to treat them as if they were. The basis of this possibility, however, points to several obligations for clinicians before such a situation can be said to exist.
Samia A Hurst
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of internal medicine     Volume:  164     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-09-14     Completed Date:  2005-02-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1757-60     Citation Subset:  AIM; E; IM    
Department of Clinical Bioethics, National Institutes of Health, Bethesda, MD, USA.
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MeSH Terms
Decision Making*
Geriatric Assessment
Mental Competency / psychology*
Physician's Role / psychology*
Physician-Patient Relations
Risk Assessment
Treatment Refusal / ethics,  psychology*
Comment In:
Arch Intern Med. 2005 Mar 14;165(5):590   [PMID:  15767542 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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