Decision making for incompetent patients

  • How can you help patients make decisions?

    Explore with the patient the level of risk they consider acceptable.
    Listen and respond to the patient's ideas, concerns, and expectations about their health.
    Present or direct the patient to credible sources of information about their condition (e.g. hospital library, web resources, pamphlets)..

  • How can you help patients make decisions?

    When patients have been deemed to lack capacity, we look to surrogate decision-makers–– their health care agent, guardian or person(s) who knows them best—for medical decisions.
    Patients who lack capacity and cannot provide informed consent retain the right to refuse medical recommendations and treatment..

  • What determines decision making capacity and competency?

    More specifically, however, capacity describes a patient's ability to make autonomous decisions regarding their care, as determined by a physician, whereas competence is a legal term that describes a person's ability to participate in legal processes, as determined by a judge..

  • What do you do when a patient Cannot make a decision?

    Explore with the patient the level of risk they consider acceptable.
    Listen and respond to the patient's ideas, concerns, and expectations about their health.
    Present or direct the patient to credible sources of information about their condition (e.g. hospital library, web resources, pamphlets)..

  • Why is decision making important in patient care?

    Shared decision making
    It ensures that you and your doctor are making treatment and healthcare decisions together.
    This process empowers you to make decisions that are right for you.
    Talk to your doctor or healthcare professional about the most appropriate shared decision-making tools for you..

  • Clinical decision making is a balance of experience, awareness, knowledge and information gathering, using appropriate assessment tools, your colleagues and evidence-based practice to guide you.
    Good decisions = safe care.
    Good, effective clinical decision making requires a combination of experience and skills.
  • More specifically, however, capacity describes a patient's ability to make autonomous decisions regarding their care, as determined by a physician, whereas competence is a legal term that describes a person's ability to participate in legal processes, as determined by a judge.
The physician generally assesses the patients' competence, but sometimes the courts are involved. The physician may be the appropriate person to choose a surrogate for a patient with limited competence or to make decisions for a totally incompetent patient.
The physician may be the appropriate person to choose a surrogate for a patient with limited competence or to make decisions for a totally incompetent patient. The surrogate may be a relative, close friend, physician who knows the patient well, or someone provided by the hospital or government.

Can patients make decisions about their own health care?

Generally, patients are free to exercise their autonomy in making decisions about their own health care.
However, patients can only do so if they are given information about and understand the risks and benefits of a specific treatment and can apply this information to their health.

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Can substitute decision makers make decisions for incompetent patients?

The modified objective reasonable person approach whose logic was just sketched requires that substitute decision makers adopt that very perspective when making decisions for incompetent patients.

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What if a patient lacks decision-making capacity?

This opinion notes that “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” .

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When should a physician engage a patient whose capacity is impaired?

Physicians should engage patients whose capacity is impaired in decisions involving their own care to the greatest extent possible, including:

  1. when the patient has previously designated a surrogate to make decisions on his or her behalf

When a patient lacks decision-making capacity, the physician has an ethical responsibility to:.

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