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Results for “Mental Competency”

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PubMed1999

[Supervision of medical scientific research with mentally competent subjects is impossible without reviewing].

The object of reviewing medical scientific research in humans is to offer guarantees against, especially, violations of physical integrity and privacy. Since the scientific interest is a matter of first importance, the research has to be checked for its reasonableness and for the test subject's consent. Omission of these checks in case the risk or stress to be expected is slight is contrary to these criteria. Reversion of the sequence of informed consent and randomization is contrary to the requirement of consent. Free, informed consent may be assumed if in a trial with a control group the test subject is informed beforehand about the study design and the risks, but is not told if he is to receive a standard therapy, a placebo or a test medication.

Clinical Trials as Topic↗
PubMed1986

Psychiatric aspects of assessment of competence of mentally retarded persons.

There are some mentally retarded, developmentally handicapped persons who--if given an appropriate, enriched, and stimulating environment--can grow, mature, and develop cognitive abilities, emotional stability, and social skills to such a degree that they may become mentally competent, capable of assuming greater responsibilities, and move away from an institution to a more dignified environment in the community, where they may be treated and have, in many ways, the same rights as any other citizens. The role of the psychiatrist is to participate in this developmental process and to give his or her opinion as to the mentally retarded person's mental capacity to live independently.

Adaptation, Psychological↗
PubMedDate not supplied

Consent to treatment in bowel interventions: some legal issues.

Bowel interventions are invasive and can be distressing for patients. In recent years there has been growing concern about how consent should be obtained for these interventions. Practitioners are becoming increasingly concerned about risk of litigation and accusations of abuse. The legal issues of consent for bowel interventions are illustrated below by means of different patient scenarios. In addition, the law relating to trespass to the person and the law relating to the duty of care to inform will be discussed in relation to mentally competent adults, mentally incapable adults, young people and children.

Administration, Rectal↗
PubMed1997

End of life decisions in amyotrophic lateral sclerosis: a cross-cultural perspective.

In an era where life-sustaining technology offers physicians unprecedented powers to prolong survival in terminal illness, the question of how end of life decisions are made has become a major subject of study and debate. Amyotrophic lateral sclerosis (ALS) is a disease in which physical ability declines while mental capacity most often remains intact. Since most patients with ALS die of respiratory failure, a distinguishing feature of this disease is whether a patient is offered and accepts a chance to go on long-term mechanical ventilation. This unusual feature makes ALS a compelling model for studying end of life decisions in different countries. This paper reviews the literature and presents preliminary data on how end of life decisions in ALS are made in the US, Great Britain, and Japan. We address this issue by examining how cultural differences in truth-telling and informed consent, societal differences in attitudes toward the use of artificial life support, and legal differences in the role and status of advance directives in each country influenced decisions in the following three groups of patients: (1) the mentally competent; (2) mentally incompetent patients who previously completed advance directives when competent; and (3) mentally incompetent patients who have not provided advance guidance about their wishes.

Amyotrophic Lateral Sclerosis↗
PubMed1981

Measurement of personal competence of mentally retarded individuals.

The development and validation of the Personal Competency Scale, a 20-item rating instrument designed to assess competence of mentally retarded adults, was described. This broad bandwidth measure provides scores on three factorially derived domain scales, which are consistent with the rationale underlying the instrument's development, and a total score. The three major dimensions of personal competence delineated were adaptive, cognitive, and affective competence. Reliability estimates in the form of interrater, test-retest, and internal consistency were high, ranging from .80 to .94 for the subscales and .90 to .97 for the total scale. Correlations between the Personal Competency Scale and criterion variables, including IQ and Adaptive Behavior Scale scores, ranged from .61 to .75. Multiple regression and canonical correlations of .85 and .87, respectively, also strongly support the validity of this new measure.

Achievement↗
PubMed2000

Performance measures of cultural competency in mental health organizations.

The authors utilized numerous documents created by advisory groups, expert panels and multicultural focus groups to develop performance measures for assessing the cultural competency of mental health systems. Competency was measured within three levels of organizational structure: administrative, provider network, and individual caregiver. Indicators, measures and data sources for needs assessment, information exchange, services, human resources, plans and policies, and outcomes were identified. Procedures for selection and implementation of the most critical measures are suggested. The products of this project are broadly applicable to the concerns of all cultural groups.

Cultural Diversity↗
PubMed1997

[Social competence and ability to make decisions].

Social competence and judgement can be separated in a somatic and in a mental competence. In mental competence, the capacity to consent has to be distinguished from the capacity to judge legal or more complex matters. Autonomy of patients requests that the capacity of consent is given, even in the presence of considerable cognitive impairment. On the other hand, competence in legal matters may be not any longer given in the presence of light to moderate cognitive impairment. In the assessment of competence, it is important that the person has the ability to make a choice, the ability to give directives, and the ability to do for oneself. Cognitively impaired patients therefore require assistance and protection in legal matters already at an early stage of the disease.

Aged↗