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Competence, Capacity, and Informed Consent: Beyond the Cognitive-Competence Model

Published online by Cambridge University Press:  31 March 2010

Eike-Henner W. Kluge
Eike-Henner W. Kluge*
Affiliation:
Centre on Aging, University of Victoria
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à : Eike-Henner W. Kluge, Ph.D., Centre on Aging, University of Victoria, Victoria, BC V8W 3P4. (ekluge@uvic.ca)
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Abstract

Only competent persons can give informed consent to health care. Current approaches define competence in essentially cognitive terms, thereby ignoring the fact that someone may be cognitively competent yet lack the capacity to give a valid consent. I outline a more robust theory of competence that includes not only cognitive but also emotional and valuational parameters. I then distinguish competence from capacity, and indicate the role this distinction can usefully play in the extended and continuing care setting. I also show how this distinction is consistent with several recent Canadian legal decisions, and outline its usefulness in interpreting and applying relevant provincial statutes.

Résumé

Seules les personnes compétentes peuvent fournir un consentement éclairé en matière de soins de santé. Les approches actuelles définissent essentiellement la compétence en termes cognitifs, omettant ainsi le fait que quelqu'un pourrait être compétent d'un point de vue cognitif sans pour autant avoir la capacité de fournir un consentement valide. Cette étude comporte une théorie plus solide de la compétence, qui comprend non seulement les paramètres cognitifs mais également les paramètres émotionnels et subjectifs. Par la suite, elle différencie la compétence de la capacité et elle indique le rôle utile que cette distinction peut jouer dans un contexte de soins continus et de longue durée. Elle démontre également la manière dont cette distinction concorde avec plusieurs décisions juridiques canadiennes récentes, et elle souligne l'utilité de celle-ci dans l'interprétation et l'application des lois provinciales pertinentes.

Keywords

capacitycompetenceinformed consentvaluesemotionsagingcapacitécompétenceconsentement éclairévaleursémotions
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 24 , Issue 3 , Fall/Automne 2005 , pp. 295 - 304
Copyright
Copyright © Canadian Association on Gerontology 2005

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