This is a concise guidebook to the assessment of patients' capacities to consent to treatment. It will help clinicians focus on the abilities that are relevant to legal definitions of competence to consent to medical and psychological treatment. With excellent case vignettes, the authors show how the interview process is carried out and offer strategies for responding to patients with limited capacities.
This work translates the complex issues surrounding competence to consent to treatment for health professionals. The authors describe the place of competence in the doctrine of informed consent and explain how the assessment should be managed.
The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) is the product of an 8-year study of patients' capacities to make treatment decisions. It is a semi-structured interview that assists clinicians in assessing a patient's competence to consent to treatment. The process provides a patient with information about their medical/psychiatric condition, the type of treatment being recommended, its risks and benefits, as well as other possible treatments and their probable consequences. During this process, the MacCAT-T prompts the clinician to ask questions that assess the patient's understanding, appreciation, and reasoning regarding treatment decisions.The MacCAT-T Manual is a large-format, examiner-friendly field manual for conducting actual competency assessments. The MacCAT-T Record Form is well designed for recording, rating, and summarizing patient responses. The training videotape, Administering the MacCAT-T, demonstrates an actual administration of the test with discussion, comments, and annotations by Drs. Grisso and Appelbaum.The book, Assessing Competence to Consent to Treatment, describes the place of competence in the doctrine of informed consent, analyzes the elements of decision making, and shows how assessments of competence to consent to treatment can be conducted within varied general medical and psychiatric treatment settings. Includes numerous case studies.
The MacCAT-CR provides a structured format for capacity assessment that is adaptable to the particulars of any given research project. With the introduction of the MacCAT-CR, researchers enrolling human participants in their studieshave available for the first time a reliable and valid means of assessing their potential subject's capacity to consent to participation. The MacCAT-CR can typically be administered in 15-20 minutes. Beginning with project-specific disclosures to potential participants, the MacCAT-CR measures the four generally accepted components of decision-making competence: understanding, appreciation, reasoning, and the ability to express a choice. Quantification of subjects' responses permits comparisons across subjects and subject groups, and allows the MacCAT-CR to be used for not only for screening individual participants but also for conducting research on the characteristics of subject populations and for assessing the effectiveness of interventions designed to increase subjects' capacities.
A timely, authoritative discussion of an important clincial topic, this useful book outlines the history, function, nature and requirements of informed consent, focusing on patient autonomy as central to the concept. Primarily a philosophical analysis, the book also covers legal aspects, with chapters on disclosure, comprehension, and competence.
This book offers a conceptual model for understanding the nature of legal competencies. The model is interpreted to assist mental health professionals in designing and performing assessments for legal competencies defined in criminal and civil law, and to guide research that will improve the practice of evaluations for legal competencies. A special feature is the book's evaluative review of specialized forensic assessment instruments for each of several legal competencies. Three-fourths of the 37 instruments reviewed in this second edition are new.
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