Faulty judgment, expert opinion, and decision-making capacity.

Full Abstract

An assessment of decision-making capacity is the accepted procedure for determining when a person is not competent. An inferential gap exists between the criteria for capacity specific abilities and the legal requirements to understand relevant information and appreciate the consequences of a decision. This gap extends to causal influences on a person's capacity to decide. Using a published case of depression, we illustrate that assessors' uses of diagnostic information is frequently not up to the task of bridging this inferential gap in a justifiable way. We then describe cases of faulty judgement which challenge the understanding of diagnostic causal influences. These cases help to clarify the nature of the expertise required for capacity assessments. In practice, the requirements of decision-making capacity are often abandoned to other considerations due to a lack of requisite expertise. The legal policy supporting decision-making capacity as a means to protective intervention is justified only if the requisite expertise is developed. We propose the requisite expertise to be developed in the long term as a distinct multidisciplinary endeavour.

Author information

Author/s: Silberfeld, M (M); Checkland, D (D);

Affiliation: Competency Clinic, Baycrest Centre for Geriatric Care, North York, ON, Canada. michel.silberfeld(-atsign-)utoronto.ca

Journal and publication information

Publication Type: Journal Article; Review

Journal: Theoretical medicine and bioethics (Theor Med Bioeth), published in NETHERLANDS. (Language: eng)

Reference: 1999-Aug; vol 20 (issue 4) : pp 377-93

Dates: Created 1999/12/09; Completed 1999/12/09; Revised 2005/11/16;

PMID: 10548932, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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