Premium
Emergency Determination of Decision‐making Capacity: Balancing Autonomy and Beneficence in the Emergency Department
Author(s) -
Larkin Gregory L.,
Marco Catherine A.,
Abbott Jean T.
Publication year - 2001
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2001.tb01307.x
Subject(s) - beneficence , medicine , autonomy , compromise , compassion , emergency department , ethical decision , medical emergency , action (physics) , risk analysis (engineering) , intensive care medicine , nursing , social psychology , psychology , social science , physics , quantum mechanics , sociology , political science , law
. The determination of decision‐making capacity (DMC) is an essential component of securing voluntary informed consent, for either treatment or refusal of care. Decision‐making capacity should be determined on some level during each patient encounter. Decision‐making capacity includes the ability to receive, process, and understand information, the ability to deliberate, the ability to make choices, and the ability to communicate those preferences. For patients in whom DMC may be uncertain, a more explicit approach to determination of DMC is recommended. However, DMC determination must neither compromise patient safety nor delay needed care. When DMC determination is challenging, or when the ramifications of a decision are serious, the assistance of a third party (such as a surrogate, a consultant, or another clinician) may be valuable in discerning the most appropriate action. In addition to the obvious clinical utility of DMC assessment, the steps taken in the very establishment of DMC may promote patient trust, professionalism, and humanistic clinical practice. While DMC may be conditional, the compassion and respect we have for our patients must be unconditional.