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August 17, 1984

Competency to Give an Informed ConsentA Model for Making Clinical Assessments

Author Affiliations

From the Department of Human Values and Ethics, University of Tennessee Medical Center, Memphis. Dr Drane is now with the Department of Philosophy, Edinboro University of Pennsylvania.

JAMA. 1984;252(7):925-927. doi:10.1001/jama.1984.03350070043021

A patient's decision must be informed and free, and he/she must be competent either to consent to or refuse treatment. Rather than selecting a single standard of competency, a sliding scale is suggested that requires an increasingly more stringent standard as the consequences of the patient's decision embody more risk. The standard of competency to consent to or to refuse treatment depends on the dangerousness of the treatment decision. Three different standards are correlated with the psychiatric abnormalities that are most likely to undermine them. A model with guidelines for use is provided to aid the physician who is called on to make a determination of competency.

(JAMA 1984;252:925-927)