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Article: Capacity to make health care decisions: its importance in clinical practice

TitleCapacity to make health care decisions: its importance in clinical practice
Authors
Issue Date1999
PublisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=PSM
Citation
Psychological Medicine, 1999, v. 29 n. 2, p. 437-446 How to Cite?
AbstractBackground. Assessment of capacity plays a pivotal role in determining when decisions need to be made on behalf of an individual. It therefore has major clinical management implications for health care professionals and civil liberties implications for the person concerned. In many countries, there is a presumption that adults have the capacity to make health care decisions. However, in persons with a mental disability, capacity may be temporarily or permanently impaired. Methods. A selective review is presented which considers: (i) the broad approaches taken to determining capacity; (ii) the abilities commonly assessed in determining capacity; and (iii) the principles underlying health care decision-making for adults who are without capacity. Results. Capacity is a functional concept, determined by the person's ability to understand, retain, and weigh up information relevant to the decision in order to arrive at a choice, and then to communicate that choice. We have reviewed the studies that examined decision-making abilities in people with dementia, chronic mental illness or intellectual disabilities. Approaches to decision-making in adults who lack capacity include: anticipatory decisions made through advance health care statements or decisions by proxy based on ‘best interests’ or ‘substituted judgement’. Conclusions. The understanding of clinical and legal aspects of capacity is still developing. This paper examines current concepts of capacity and decision-making on behalf of those without capacity. We propose a framework, in line with current ethical and legal guidelines, as an aid to clinicians when they are seeking consent for a health care intervention.
Persistent Identifierhttp://hdl.handle.net/10722/42510
ISSN
2015 Impact Factor: 5.491
2015 SCImago Journal Rankings: 2.843
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, JGWSen_HK
dc.contributor.authorClare, ICHen_HK
dc.contributor.authorGunn, MJen_HK
dc.contributor.authorHolland, AJen_HK
dc.date.accessioned2007-01-29T08:51:32Z-
dc.date.available2007-01-29T08:51:32Z-
dc.date.issued1999en_HK
dc.identifier.citationPsychological Medicine, 1999, v. 29 n. 2, p. 437-446en_HK
dc.identifier.issn0033-2917en_HK
dc.identifier.urihttp://hdl.handle.net/10722/42510-
dc.description.abstractBackground. Assessment of capacity plays a pivotal role in determining when decisions need to be made on behalf of an individual. It therefore has major clinical management implications for health care professionals and civil liberties implications for the person concerned. In many countries, there is a presumption that adults have the capacity to make health care decisions. However, in persons with a mental disability, capacity may be temporarily or permanently impaired. Methods. A selective review is presented which considers: (i) the broad approaches taken to determining capacity; (ii) the abilities commonly assessed in determining capacity; and (iii) the principles underlying health care decision-making for adults who are without capacity. Results. Capacity is a functional concept, determined by the person's ability to understand, retain, and weigh up information relevant to the decision in order to arrive at a choice, and then to communicate that choice. We have reviewed the studies that examined decision-making abilities in people with dementia, chronic mental illness or intellectual disabilities. Approaches to decision-making in adults who lack capacity include: anticipatory decisions made through advance health care statements or decisions by proxy based on ‘best interests’ or ‘substituted judgement’. Conclusions. The understanding of clinical and legal aspects of capacity is still developing. This paper examines current concepts of capacity and decision-making on behalf of those without capacity. We propose a framework, in line with current ethical and legal guidelines, as an aid to clinicians when they are seeking consent for a health care intervention.en_HK
dc.format.extent191180 bytes-
dc.format.extent26112 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypeapplication/msword-
dc.languageengen_HK
dc.publisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=PSMen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsPsychological Medicine. Copyright © Cambridge University Press.en_HK
dc.subject.meshDecision makingen_HK
dc.subject.meshMental competencyen_HK
dc.subject.meshmental disorders - psychologyen_HK
dc.subject.meshPatient acceptance of health careen_HK
dc.subject.meshMental retardationen_HK
dc.titleCapacity to make health care decisions: its importance in clinical practiceen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0033-2917&volume=29&issue=2&spage=437&epage=446&date=1999&atitle=Capacity+to+make+health+care+decisions:+its+importance+in+clinical+practiceen_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1017/S0033291798008113en_HK
dc.identifier.pmid10218935-
dc.identifier.scopuseid_2-s2.0-0033052072-
dc.identifier.hkuros45752-
dc.identifier.isiWOS:000079429800020-

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