What defines decision-making capacity?
The phrase “decision-making capacity” refers to a potential participant’s ability to make a meaningful decision about whether or not to participate.
What is refusal of treatment?
The right to refuse treatment applies to those who cannot make medical decisions for themselves, as well as to those who can; the only difference is how we protect the rights of people who cannot make decisions for themselves (see VEN’s free handbook Making Medical Decisions for Someone Else).
When a patient lacks decision-making capacity?
When a patient lacks decision-making capacity, the physician has an ethical responsibility to: Identify an appropriate surrogate to make decisions on the patient’s behalf: The person the patient designated as surrogate through a durable power of attorney for health care or other mechanism.
What are the 4 decision-making abilities that constitute capacity?
Four Component Model of Decisional Capacity. Capacity for healthcare is generally defined in terms of four dimensions or criteria: (a) Understanding, (b) Appreciation, (c) Reasoning, and (d) Expression of a Choice (Grisso & Appelbaum, 1998a; Roth, Meisel, & Lidz, 1977).
How do you determine capacity to make medical decisions?
Determining whether an individual has adequate capacity to make decisions is therefore an inherent aspect of all clinician-patient interactions. The main determinant of capacity is cognition, and any condition or treatment that affects cognition may potentially impair decision-making capacity.
How would you deal with a patient who refuses treatment?
Patients who refuse treatment You must respect a competent patient’s decision to refuse an investigation or treatment, even if you think their decision is wrong or irrational. You may advise the patient of your clinical opinion, but you must not put pressure on them to accept your advice.
Can a patient without capacity refusing treatment?
Competent adults can refuse specified treatment for a time in the future when they may lose capacity. This is called an advance decision refusing treatment, sometimes known colloquially as a living will. Patients can only refuse treatment by means of an advance decision, they cannot commission treatment in advance.
What happens if a person is unable to make a decision?
The Court of Protection was set up to protect people who are unable to make decisions about their personal health, welfare or finance. The Court has the power to make decisions about a person’s personal welfare and can decide whether to provide, withdraw or withhold medical treatment from a person who lacks capacity.
How do you assess a patient’s decision-making capacity?
Patients have medical decision-making capacity if they can demonstrate understanding of the situation, appreciation of the consequences of their decision, and reasoning in their thought process, and if they can communicate their wishes.
When should an individual’s capacity to make a decision be assessed?
A mental capacity assessment must be carried out when:
- There are indicators that the person may not be able to make the decision at the time that it needs to be made; and.
- There is evidence that the person has (or may have) an impairment of, or disturbance in the functioning of the mind or brain; and.
Why is refusal of treatment an ethical dilemma?
In general, ethical tension exists when a physician’s obligation to promote a patient’s best interests competes with the physician’s obligation to respect the patient’s autonomy. “When you don’t take your medication, you’re more likely to get sick.”
What is meant by refusal of consent?
“Although the term ‘consent’ implies acceptance of treatment, the concept of informed consent applies equally to refusal of treatment or to choice among alternative treatments. Competent patients have the right to refuse treatment, even when the refusal will result in disability or death.”
What happens if a patient refuses medication?
Because a client legally has the right to refuse medication, the nurse can only recommend, advise, suggest, or urge the patient to comply. Consequently, it is important to understand the nurse’s response to patient refusal of medication.
What to do if a patient refuses treatment?
Understand their story Try to understand the patient/family’s story before you try to change their mind. This means suspending your attitude toward their decision and as openly and non-judgmentally as possible, understanding the reasons for their decision.
How can you support a person who is legally unable to make decisions?
Giving the person relevant information to make the decision. Keep the information only to what is needed. Describe any foreseeable risks and benefits in practical terms. If there are options, give the information about the choices in a clear and balanced way.