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Article: The capacity of people with a ‘mental disability’ to make a health care decision

TitleThe capacity of people with a ‘mental disability’ to make a health care decision
Authors
Issue Date2000
PublisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=PSM
Citation
Psychological Medicine, 2000, v. 30 n. 2, p. 295-306 How to Cite?
AbstractBackground. Based on the developing clinical and legal literature, and using the framework adopted in draft legislation, capacity to make a valid decision about a clinically required blood test was investigated in three groups of people with a ‘mental disability’ (i.e. mental illness (chronic schizophrenia), ‘learning disability’ (‘mental retardation’, or intellectual or developmental disability), or, dementia) and a fourth, comparison group. Methods. The three ‘mental disability’ groups (N = 20 in the ‘learning disability’ group, N = 21 in each of the other two groups) were recruited through the relevant local clinical services; and through a phlebotomy clinic for the ‘general population’ comparison group (N = 20). The decision-making task was progressively simplified by presenting the relevant information as separate elements and modifying the assessment of capacity so that responding became gradually less dependent on expressive verbal ability. Results. Compared with the ‘general population’ group, capacity to make the particular decision was significantly more impaired in the ‘learning disability’ and ‘dementia’ groups. Importantly, however, it was not more impaired among the ‘mental illness’ group. All the groups benefited as the decision-making task was simplified, but at different stages. In each of the ‘mental disability’ groups, one participant benefited only when responding did not require any expensive verbal ability. Conclusions. Consistent with current views, capacity reflected an interaction between the decision-maker and the demands of the decision-making task. The findings have implications for the way in which decisions about health care interventions are sought from people with a ‘mental disability’. The methodology may be extended to assess capacity to make other legally-significant decisions.
Persistent Identifierhttp://hdl.handle.net/10722/42511
ISSN
2023 Impact Factor: 5.9
2023 SCImago Journal Rankings: 2.768
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, JGWSen_HK
dc.contributor.authorClare, ICHen_HK
dc.contributor.authorHolland, AJen_HK
dc.contributor.authorWatson, PCen_HK
dc.contributor.authorGunn, Men_HK
dc.date.accessioned2007-01-29T08:51:34Z-
dc.date.available2007-01-29T08:51:34Z-
dc.date.issued2000en_HK
dc.identifier.citationPsychological Medicine, 2000, v. 30 n. 2, p. 295-306en_HK
dc.identifier.issn0033-2917en_HK
dc.identifier.urihttp://hdl.handle.net/10722/42511-
dc.description.abstractBackground. Based on the developing clinical and legal literature, and using the framework adopted in draft legislation, capacity to make a valid decision about a clinically required blood test was investigated in three groups of people with a ‘mental disability’ (i.e. mental illness (chronic schizophrenia), ‘learning disability’ (‘mental retardation’, or intellectual or developmental disability), or, dementia) and a fourth, comparison group. Methods. The three ‘mental disability’ groups (N = 20 in the ‘learning disability’ group, N = 21 in each of the other two groups) were recruited through the relevant local clinical services; and through a phlebotomy clinic for the ‘general population’ comparison group (N = 20). The decision-making task was progressively simplified by presenting the relevant information as separate elements and modifying the assessment of capacity so that responding became gradually less dependent on expressive verbal ability. Results. Compared with the ‘general population’ group, capacity to make the particular decision was significantly more impaired in the ‘learning disability’ and ‘dementia’ groups. Importantly, however, it was not more impaired among the ‘mental illness’ group. All the groups benefited as the decision-making task was simplified, but at different stages. In each of the ‘mental disability’ groups, one participant benefited only when responding did not require any expensive verbal ability. Conclusions. Consistent with current views, capacity reflected an interaction between the decision-maker and the demands of the decision-making task. The findings have implications for the way in which decisions about health care interventions are sought from people with a ‘mental disability’. The methodology may be extended to assess capacity to make other legally-significant decisions.en_HK
dc.format.extent295819 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.rightsPsychological Medicine. Copyright © Cambridge University Press.en_HK
dc.subject.meshInformed consent - legislation & jurisprudenceen_HK
dc.subject.meshSchizophrenia - diagnosisen_HK
dc.subject.meshSchizophrenic psychologyen_HK
dc.subject.meshBlood specimen collectionen_HK
dc.subject.meshAdolescenten_HK
dc.titleThe capacity of people with a ‘mental disability’ to make a health care decisionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0033-2917&volume=30&issue=2&spage=295&epage=306&date=2000&atitle=The+capacity+of+people+with+a+‘mental+disability’+to+make+a+health+care+decisionen_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1017/S0033291700001768en_HK
dc.identifier.pmid10824650-
dc.identifier.scopuseid_2-s2.0-0034014378-
dc.identifier.isiWOS:000087096900005-
dc.identifier.issnl0033-2917-

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