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  1. Capacity to make health care decisions : its importance in clinical practice.

    Article - En anglais


    Assessment of capacity plays a pivotal role in determining when decisions need to be made on behalf of an individual.

    It therefore has major clinical management implications for health care professionals and civil liberties implications for the person concerned.

    In many countries, there is a presumption that adults have the capacity to make health care decisions.

    However, in persons with a mental disability, capacity may be temporarily or permanently impaired.


    A selective review is presented which considers :

    • (i) the broad approaches taken to determining capacity ;

    • (ii) the abilities commonly assessed in determining capacity ;

    • and (iii) the principles underlying health care decision-making for adults who are without capacity.


    Capacity is a functional concept, determined by the person's ability to understand, retain, and weigh up information relevant to the decision in order to arrive at a choice, and then to communicate that choice.

    We have reviewed the studies that examined decision-making abilities in people with dementia, chronic mental illness or intellectual disabilities.

    Approaches to decision-making in adults who lack capacity include : anticipatory decisions made through advance health care statements or decisions by proxy based on'best interests'or'substituted judgement'Conclusions.

    The understanding of clinical and legal aspects of capacity is still developing. (...)

    Mots-clés Pascal : Prise décision, Santé mentale, Trouble psychiatrique, Arriération mentale, Ethique, Législation, Angleterre, Grande Bretagne, Royaume Uni, Europe, Pays de Galles, Homme, Déficience intellectuelle, Trouble développement

    Mots-clés Pascal anglais : Decision making, Mental health, Mental disorder, Mental retardation, Ethics, Legislation, England, Great Britain, United Kingdom, Europe, Wales, Human, Intellectual deficiency, Developmental disorder

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0220989

    Code Inist : 002B18H05C. Création : 16/11/1999.