下面是培臻教育小编为大家整理的一篇关于UKCAT考试：关键医学概念-能力的文章，供大家参考，下面是详细内容。
关键医学概念-能力
In a previous blog, I began to discuss the topic of
medical law, a vast world of legal conundrums, cases and court rulings, and
touched on the topic of consent. Another vital medicolegal concept that is
ubiquitous throughout medical ethics questions is that of capacity. Here’s a brief explanation and summary of capacity tohelp give you an additional perspective on some of your future interviewquestions.
What is Capacity?
Capacity is inextricably linked to consent, with
the former being a necessity for the later. Patient’s require capacity to give informed consent, and
those who lack capacity are unable to give consent, and will have medical
decisions made on their behalf. Capacity is generally defined as the attribute
of having sufficient understanding and memory to comprehend a given situation
(in this context, often a diagnosis), the treatment options available and the
consequences of these options. Clearly, patients who lack these attributes
would be unable to become‘informed’to give their consent and, as such, are unableto provide informed consent.
Who Lacks Capacity?
The first large group of those who lack capacity
are children. This is based on the premise that children lack the understanding
to comprehend medical situations and consequences of treatments. Generally, the
threshold for being able to consent is sixteen years old, with parent (or
guardians) deciding treatments for their children below this age. Interesting
legal arguments arise when children disagree with parent’s medical choices (for many reasons e.g. religiousbeliefs), but are below the age of sixteen. However, if a child can demonstratecapacity (i.e. demonstrate that they are able to understand thetreatment/intervention and comprehend the risks) then doctors may treat them asif they have capacity. A common topic within in which this is discussed is thatof contraception, and whether contraception should be given to those below theage of 16.
A second group of individuals who lack capacity are
those who are being detained and treated for a mental illness. Patients with
mental illnesses may be unable to comprehend their illness due to the effects
of having a mental illness. For example, patient with schizophrenia will often
have delusions that prevent them being able to understand that they have
schizophrenia, and that their delusions are a result of their mental illness.
These patients are sometimes detained for prolonged treatment under Section 3
of the Mental Health Act (a bit of law that allows these people to be detained
for treatment). This means these patients will be detained until they have
received treatment and their medical care decided by doctors. An important
point to be aware of is that these individuals only lack capacity to decide
treatment for their mental illness, not other health conditions. An interesting
example of this is the case of Re: C, a paranoid schizophrenic who did not want
to have his leg amputated, even though this decision was potentially
life-threatening. He was found to have capacity to make this decision and a
judge ruled that, though his decision was not sensible, he had the right to
make it under patient autonomy. One issue I personally find with this ruling is
that C was under the delusion that he was a world-leading surgeon due to his
mental illness–arguably a confounding factor in his decisionto decline treatment.
Another group of patients who lack capacity are
those with profound memory deficits, such as individuals with Alzheimer’s. These patients do not have sufficient memory toretain information about their conditions long enough to make an informeddecision. However, every opportunity should be made to involve patients indecisions regarding their medical care.
Capacity, an important concept at the heart of manymedical ethics questions and often an area overlooked by students. A little bitof knowledge will go a long way to setting you apart from the crowd.
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