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Tables of Contents for Assessing Competence to Consent to Treatment
Chapter/Section Title
Page #
Page Count
1. Why Competence Is Important: The Doctrine of Informed Consent
1
16
The Case of the Bewildered Janitor
2
1
Consent to Medical Treatment: Historical Evolution
3
4
The Elements of Informed Consent
7
4
The Importance of Competence
11
3
Summary
14
3
2. Thinking About Competence
17
14
Five Maxims of Legal Competence
18
10
Implications for Assessment Objectives
28
2
Summary
30
1
3. Abilities Related to Competence
31
30
Expressing a Choice
34
3
Understanding
37
5
Appreciation
42
10
Reasoning
52
6
Summary
58
3
4. When Patients' Decision Making Should Be Assessed
61
16
Abrupt Changes in Patients' Mental State
62
1
When Patients Refuse Treatment
63
3
When Patients Consent to Treatment That Will Be Especially Invasive or Risky
66
2
When Patients Display One or More Risk Factors for Impaired Decision Making
68
8
Summary
76
1
5. Assessing Patients' Capacities to Consent to Treatment
77
24
Who Should Perform the Assessment of Decision-Making Capacities?
77
3
Conducting the Assessment
80
12
Techniques to Maximize Patients' Performance
92
7
Summary
99
2
6. Using the MacArthur Competence Assessment Tool -- Treatment
101
26
Overview of the MacCAT-T
102
3
Overview of Administration and Rating
105
3
Preparing for the MacCAT-T Interview
108
6
Performing the MacCAT-T Interview
114
5
Rating the Responses
119
1
Using MacCAT-T Ratings
120
6
Summary
126
1
7. Making Judgments About Patients' Competence
127
22
The Process of Reaching Competence Judgments
127
14
Reaching a Conclusion
141
4
Documenting the Competence Evaluation
145
2
After the Judgment
147
1
Summary
147
2
8. Substitute Decision Making for Incompetent Patients
149
20
Patients as Decision Makers: Advance Directives
149
8
Families as Decision Makers
157
4
The Courts as Decision Makers
161
3
How Should Decisions Be Made?
164
4
Summary
168
1
References
169
4
Appendix: Manual for the MacArthur Competence Assessment Tool -- Treatment (MacCAT-T)
173
1
Preparation
174
2
Interview
176
7
Rating
183
7
Interpretations
190
11
Index
201