Patient decision making competence: outlines of a conceptual analysis.

Jos V. M. Welie, S. P. Welie

Research output: Contribution to journalReview article

33 Citations (Scopus)

Abstract

In order to protect patients against medical paternalism, patients have been granted the right to respect of their autonomy. This right is operationalized first and foremost through the phenomenon of informed consent. If the patient withholds consent, medical treatment, including life-saving treatment, may not be provided. However, there is one proviso: The patient must be competent to realize his autonomy and reach a decision about his own care that reflects that autonomy. Since one of the most important patient rights hinges on the patient's competence, it is crucially important that patient decision making incompetence is clearly defined and can be diagnosed with the greatest possible degree of sensitivity and, even more important, specificity. Unfortunately, the reality is quite different. There is little consensus in the scientific literature and even less among clinicians and in the law as to what competence exactly means, let alone how it can be diagnosed reliably. And yet, patients are deemed incompetent on a daily basis, losing the right to respect of their autonomy. In this article, we set out to fill that hiatus by beginning at the very beginning, the literal meaning of the term competence. We suggest a generic definition of competence and derive four necessary conditions of competence. We then transpose this definition to the health care context and discuss patient decision making competence.

Original languageEnglish
Pages (from-to)127-138
Number of pages12
JournalMedicine, Healthcare and Philosophy
Volume4
Issue number2
StatePublished - 2001

Fingerprint

Mental Competency
Decision Making
decision making
autonomy
respect
patient's rights
paternalism
Paternalism
technical literature
physician's care
Literature
Conceptual Analysis
Patient Rights
Informed Consent
health care
Consensus
Law
Delivery of Health Care
Therapeutics
Autonomy

All Science Journal Classification (ASJC) codes

  • Philosophy
  • Public Health, Environmental and Occupational Health
  • Health(social science)

Cite this

Patient decision making competence : outlines of a conceptual analysis. / Welie, Jos V. M.; Welie, S. P.

In: Medicine, Healthcare and Philosophy, Vol. 4, No. 2, 2001, p. 127-138.

Research output: Contribution to journalReview article

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