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Decision Making Capa
Decision Making Capacity-OM 4
| Question | Answer |
|---|---|
| Why is Decision Making Capacity important ? | * it determines whether or not patients will have control over the decisions made for them......if no advanced directive or previous discussion about treatments |
| Physician respect and DMC ? | * they respect it, unless the patient lacks decision making capacity |
| If Dr. proceeds with procedure when patient has DMC and refused ? | * constitutes as assault and battery |
| If Dr. honors a patient that refused treatment, but lacks DMC ? | * if Dr. honors it, the patient could be subjected to needless harm |
| Parts to a proper consent from a patient to receive a certain treatment ? | Patient must posses: * capacity to understand and communicate * ability to reason * have a set of values and goals -others = consent is voluntary and understand consequences |
| When to assess DMC ? | * before asking consent.....during H&E |
| Capacity vs. Competence ? | * Capacity - clinically determined by physician * Competence - court/legal determinations by courts/judges |
| People who are deemed competent by the courts can have what issue? | * they ARE court ruled competent, but may LACK capacity to make certain decisions * why DMC should be determined by physicians rather than courts |
| Ethical questions brought to light when DMC is questionable ? | * respect autonomy * Dr. should act in patients best interests |
| If DMC is seriously impaired ? | * DMC is taken from patient and given to a surrogate |
| Abilities a patient must possess to make health care decisions ? | * understand condition *understand risks/consequences/benefits *value/weigh options of treatment v. non-treatment to their goals *to reason and deliberate options *to communicate decisions in a meaningful manner |
| Role of Mental Status Testing ? | *tests orientation (person, place, time, and situation) * tests cognitive skills *** NONE test to see if they understand what their problem is or consequences of tmt vs. non-tmt |
| From nurses to the physicians can assess DMC, but who is held responsible for the final decision ? | * the attending physician (no psychiatrist needed) |
| Some helpful things to do to help determine DMC ? | * ask them to describe their issue, possible consequences, and what brought on the issue. |
| If patients advanced aged, demented, retarded, or depressed ? | * may still possess DMC |
| DMC as it is related to different tasks ? (ex. bd drawn vs. advanced directives) | * is task-related -patients may understand and have sufficient DMC for a simple task, but not for a more advanced task |
| DMC and permanence ? | * may have DMC at one time, and not the next -if possible, delay decisions until reversible problems are corrected (ex. infection, electrolyte imbalance, medication effect) |
Created by:
thamrick800
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