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When Does Decisional Impairment Become Decisional Incompetence? Ethical and Methodological Issues in Capacity Research in Schizophrenia

机译:决策障碍何时会成为决策无能?精神分裂症能力研究中的伦理学和方法论问题

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摘要

Most decision-making capacity (DMC) research has focused on measuring the decision-making abilities of patients, rather than on how such persons may be categorized as competent or incompetent. However, research ethics policies and practices either assume that we can differentiate or attempt to guide the differentiation of the competent from the incompetent. Thus there is a need to build on the recent advances in capacity research by conceptualizing and studying DMC as a categorical concept. This review discusses why there is a need for such research and addresses challenges and obstacles, both practical and theoretical. After a discussion of the potential obstacles and suggesting ways to overcome them, it discusses why clinicians with expertise in capacity assessments may be the best source of a provisional “gold standard” for criterion validation of categorical capacity status. The review provides discussions of selected key methodological issues in conducting research that treats DMC as a categorical concept, such as the issue of the optimal number of expert judges needed to generate a criterion standard and the kinds of information presented to the experts in obtaining their judgments. Future research needs are outlined.
机译:大多数决策能力(DMC)研究都集中在衡量患者的决策能力上,而不是在如何将这些人归类为胜任或不胜任的人。但是,研究伦理政策和实践要么假设我们可以区分,要么试图引导胜任者与不胜任者的区分。因此,有必要通过将DMC概念化和研究作为一种分类概念,在能力研究的最新进展的基础上继续前进。这篇综述讨论了为什么需要进行这样的研究并解决了实际和理论上的挑战和障碍。在讨论了潜在的障碍并提出了克服这些障碍的方法之后,它讨论了为什么在能力评估方面具有专业知识的临床医生可能是临时的“金标准”的最佳来源,用于分类能力状态的标准验证。该评论讨论了将DMC视为分类概念的研究中选定的关键方法论问题,例如生成标准标准所需的最佳专家法官人数以及在获得专家意见时提供给专家的信息种类。概述了未来的研究需求。

著录项

  • 来源
    《Schizophrenia Bulletin》 |2006年第1期|92-97|共6页
  • 作者

    Scott Y H Kim;

  • 作者单位

    Department of Psychiatry;

    Bioethics Program;

    Center for Behavioral and Decision Sciences in Medicine University of Michigan 300 North Ingalls Street 7C27 Ann Arbor MI 48109;

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  • 原文格式 PDF
  • 正文语种 eng
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  • 入库时间 2022-08-18 01:07:41

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