基于价值的能力评估方法。

IF 0.3 4区 医学 Q3 LAW
Jacob M Appel
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引用次数: 4

摘要

在临床环境中,评估病人决策能力的主要方法是“四项技能”和“滑动量表”模型,它们出现在20世纪70年代和80年代的医疗家长制背景下,反映了它们在法律和法医精神病学中的起源。他们推崇理性,要求有能力用知识和论证来捍卫自己的决定。不幸的是,这些方法给患者带来了沉重的负担,他们可能持有与其潜在价值观一致的偏好,但可能不具备满足当前能力标准所施加的沉重负担所需的教育或推理技能。本文回顾了主流模型的不足。然后,文章提出了一种新的基于价值的能力评估方法,该方法主要强调患者的潜在和长期价值观,以及这些价值观与患者当前愿望和偏好的一致性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Values-Based Approach to Capacity Assessment.

The dominant approaches to assessing patients for decisional capacity in the clinical setting, the "four skills" and "sliding scale" models, emerged in the 1970s and 1980s against a backdrop of medical paternalism and reflect their origins in law and forensic psychiatry. They privilege rationality and require the ability to defend one's decisions with knowledge and argument. Unfortunately, these approaches place a heavy burden upon patients who may hold preferences consistent with their underlying values but may not possess the education or reasoning skills necessary to meet the heavy burden imposed by current capacity standards. This article reviews the shortcomings of the dominant models. Then the article proposes a novel value-based approach to capacity assessment that places primary emphasis upon the patient's underlying and longstanding values and the concordance of those values with the patient's current wishes and preferences.

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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
3
期刊介绍: The Journal of Legal Medicine is the official quarterly publication of the American College of Legal Medicine (ACLM). Incorporated in 1960, the ACLM has among its objectives the fostering and encouragement of research and study in the field of legal medicine. The Journal of Legal Medicine is internationally circulated and includes articles and commentaries on topics of interest in legal medicine, health law and policy, professional liability, hospital law, food and drug law, medical legal research and education, the history of legal medicine, and a broad range of other related topics. Book review essays, featuring leading contributions to the field, are included in each issue.
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