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Evaluation of decision-making capacity in patients with dementia: challenges and recommendations from a secondary analysis of qualitative interviews
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
 
ID 4604936
Author(s) Poppe, Christopher; Elger, Bernice S.; Wangmo, Tenzin; Trachsel, Manuel
Author(s) at UniBasel Wangmo, Tenzin
Poppe, Christopher
Elger, Bernice Simone
Year 2020
Title Evaluation of decision-making capacity in patients with dementia: challenges and recommendations from a secondary analysis of qualitative interviews
Journal BMC Medical Ethics
Volume 21
Number 1
Pages / Article-Number 55
Keywords Autonomy; Competence; Decision-making capacity; Dementia; Ethics; Informed consent
Abstract Evaluation of decision-making capacity to consent to medical treatment has proved to be difficult in patients with dementia. Studies showed that physicians are often insufficiently trained in the evaluation of decision-making capacity. In this study, we present findings from a secondary analysis of a qualitative interviews with physicians. These interviews were initially used to assess usability of an instrument for the evaluation of decision-making capacity. By looking at difficult cases of decision-making capacity evaluation in patients with dementia, we provide recommendations for such evaluations in clinical practice.; We used thematic coding to analyse physicians' narratives of problematic decision-making capacity evaluations in patients with dementia to uncover challenging issues of decision-making capacity evaluation.; In this study, decision-making capacity evaluations in patients with dementia were mainly perceived as challenging when they pertained to treatment refusals and treatment unrelated circumstances, such as psychiatric consultation, advance directives, and new living arrangements. Furthermore, the physicians reported training needs regarding situation-independent challenges with decision-making capacity evaluation.; Upon further examining self-reported training needs and challenging cases, we have developed recommendations to improve decision-making capacity evaluations in clinical practice. In these recommendations, we argue that being able to evaluate decision-making capacity is an integral part of the informed consent process.
Publisher BioMed Central
ISSN/ISBN 1472-6939
URL https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7339476/
edoc-URL https://edoc.unibas.ch/78819/
Full Text on edoc No
Digital Object Identifier DOI 10.1186/s12910-020-00498-y
PubMed ID http://www.ncbi.nlm.nih.gov/pubmed/32631304
ISI-Number WOS:000550085700002
Document type (ISI) Journal Article
 
   

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