Competence to Consent

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Georgetown University Press, 16.09.1994 г. - 224 страници

Free and informed consent is one of the most widespread and morally important practices of modern health care; competence to consent is its cornerstone. In this book, Becky Cox White provides a concise introduction to the key practical, philosophical, and moral issues involved in competence to consent.

The goals of informed consent, respect for patient autonomy and provision of beneficent care, cannot be met without a competent patient. Thus determining a patient's competence is the critical first step to informed consent. Determining competence depends on defining it, yet surprisingly, no widely accepted definition of competence exists. White identifies nine capacities that patients must exhibit to be competent. She approaches the problem from the task-oriented nature of decision making and focuses on the problems of defining competence within clinical practice. Her proposed definition is based on understanding competence as occurring in a special rather than a general context; as occurring in degrees rather than at a precise threshold; as independent of consequential appeals; and as incorporating affective as well as cognitive capacities.

Combining both an ethical overview and practical guidelines, this book will be of value to health care professionals, bioethicists, and lawyers.

 

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Съдържание

Competence in the Health Care Setting
1
WHY COMPETENCE IS AN ISSUE
3
WHEN COMPETENCE IS IN QUESTION
7
WHY THE LAW IS NO HELP
10
SUMMARY
11
NOTES
12
Ethical Foundations of Competence to Consent
13
COMPETENCE AND THE PRINCIPLE OF BENEFICENCE
18
GENERAL VS SPECIFIC COMPETENCE
83
THRESHOLD VS DECREE COMPETENCE
95
CONSEQUENCEDEPENDENT VS CONSEQUENCEINDEPENDENT COMPETENCE
106
COGNITIVE VS COGNITIVEAFFECTIVE COMPETENCE
117
SUMMARY
144
NOTES
146
The Capacities that Define Competence to Consent
154
INFORMABILITY AND DECISION MAKING
157

BENEFICENCE THROUGH AUTONOMY
24
COMPETENCE AND THE PRACTICE OF INFORMED CONSENT
27
MORAL IMPLICATIONS OF INFORMED CONSENT
35
NOTES
37
Current Confusion Surrounding the Concept of Competence
44
CURRENT PROBLEMS WITH THE CONCEPT OF COMPETENCE
53
SUMMARY
74
NOTES
75
Defining the Structure of Competence to Consent
82
COGNITIVE AND AFFECTIVE CAPABILITY
167
RESOLUTION AND RESIGNATION IN DECISION MAKING Resolution
177
RECOUNTING ONES DECISIONMAKING PROCESS
180
CONCLUSIONS
183
Implications and Anticipated Criticisms
185
ANTICIPATING THE CRITIC
187
Bibliography
193
Index
203
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Информация за автора (1994)

Becky Cox White is an assistant professor of philosophy at California State University Chico. She received a PhD from Rice University and has extensive nursing experience.

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