Citation

Kitamura T, Hiramura H. Curr. Opin. Psychiatry 2004; 17(6): 493-496.

Copyright

(Copyright © 2004, Lippincott Williams and Wilkins)

DOI

10.1097/00001504-200411000-00012

PMID

unavailable

Abstract

PURPOSE of review: Competency assessment is an important part of the doctrine of informed consent. A review of the psychometric and theoretical reports on this topic is timely. Recent findings: Instruments to measure patients' competency to give informed consent, such as the MacArthur Competency Assessment Tool-Treatment as described by Grisso et al. in 1998, have been widely studied for their validity and reliability. Scores of competency were reported to be less specific to diagnostic categories, and more correlated with cognitive function. Some researchers argued that the level of competency could be improved by education. The 'non-suicide contract', a frequently used method in suicide prevention, has been criticized for its lack of ethical grounding. Competency assessment is now an issue in other branches of medicine. For example, it is used to protect living liver donors from exploitation. Theoretical arguments swing between paternalism and anti-paternalism. A means to resolve this issue may be a relation-based approach to the doctrine of informed consent. Summary: Active research in competency assessment is leading to a new stage of theoretical formulation and practical improvement.

Language: en

Keywords

human; cognition; suicide; psychiatry; Assessment; ethics; review; informed consent; psychometry; reliability; paternalism; curriculum; Autonomy; Competency; Informed consent; living donor; Medical decision-making