Competency: general principles and applicability in dementia

Neurología : publicación oficial de la Sociedad Española de Neurología
L C Alvaro

Abstract

Competency means the capacity to make responsible and balanced decisions. This may be performed in clinical settings (decision-making abilities on treatment or risky diagnostic procedures) and also in daily-life activities (financial matters, nursing home admittance, contracts, etc.). Competency is linked to the ethical principle of autonomy and to a horizontal doctor-patient interaction, far from ancient paternalistic relationships. It is contemplated in the Spanish law as the patient's right to be informed and to make free choices, particularly in cases of dementia. The competency that we assess is the so-called natural or working capacity. It is specific for an action or task. The level of required capacity depends on the decision: higher for critical ones, lower for low-risk decisions. The assessment process requires noting the patient's capacity to understand, analyse, self-refer and apply the information. There are some guides available that may be useful in competency assessments, but nevertheless the final statement must be defined by the physician in charge of the patient and clinical judgement. Capacity is directly related to the level of cognitive deterioration. Nevertheless, specific cognitive tests like MMSE (mini-...Continue Reading

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Citations

Sep 17, 2013·Semergen·F J Atienza-MartínG Marín-Andrés
Sep 18, 2012·Neurología : publicación oficial de la Sociedad Española de Neurología·E L Gómez-DuránJ Arimany-Manso
Sep 18, 2012·Neurología : publicación oficial de la Sociedad Española de Neurología·L C Álvaro González
May 15, 2018·The Nurse Practitioner·Jason T SlyerMarie Truglio-Londrigan
May 1, 2021·Vaccines·Nunzia CannovoMariano Cingolani

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