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- Title
PATIENTENRECHTE UND PATIENTENSICHERHEIT.
- Authors
Ganner, Michael; Kröll, Wolfgang
- Abstract
The article "Patient Rights and Patient Safety" deals with the medical and legal assessment of patients' decision-making capacity. It is pointed out that the skills required by healthcare professionals for decision-making capacity do not always correspond to the legal requirements. A stronger orientation towards legal regulations would bring more legal certainty for healthcare professionals. Especially in the context of demographic change and the increase in elderly and sick people, decision-making capacity is of great importance. Various approaches to assessing decision-making capacity are discussed, including the involvement of specialist doctors in psychiatry or internal medicine with additional training in geriatrics. The comprehensive geriatric assessment is a multidimensional and interdisciplinary process carried out to assess a person's medical, psychosocial, and functional resources. It serves to objectify functional impairments such as limited self-help ability, mobility restrictions, risk of falling, and cognitive abilities. Within this assessment, various tests are used to assess a patient's cognitive abilities, including the Watson Clock Test and the Mini-Mental State Examination (MMSE). An MMSE attempts to evaluate and assess cognitive impairments. However, a comprehensive geriatric assessment cannot draw conclusions about a patient's decision-making capacity. The assessment of decision-making capacity is best done through targeted questioning of the patient. If the patient can answer certain questions correctly, decision-making capacity is presumed. The article deals with the decision-making capacity of patients regarding medical treatments. It is noted that doctors often do not have enough time to engage intensively with patients and that they often give up quickly. It is emphasized that doctors are obligated to at least attempt to bring about patients' decision-making capacity for planned elective procedures. The legal criteria for decision-making capacity are explained, including the capacity for understanding and the capacity for forming a will. It is emphasized that patients' autonomy entitles them to make unreasonable decisions as well. The article addresses patients' decision-making capacity and support in the decision-making process. It is noted that the assessment of decision-making capacity is a legal question and that experts such as specialist doctors in psychiatry and psychology must establish the facts. In cases of deficits in will formation or behavioral control, professionals or close individuals can provide supportive assistance. However, in clinical practice, there may be borderline cases where the limitation of cognitive functions is not clearly recognizable, and in such cases, a geriatric consultation can be helpful.
- Subjects
MEDICAL care; MINI-Mental State Examination; CONTROL (Psychology); MEDICAL personnel; MEDICAL decision making; OLDER patients; PATIENTS' rights; COGNITIVE ability; DEMOGRAPHIC change; PATIENT autonomy; GERIATRIC psychiatry
- Publication
Journal für Medizin- und Gesundheitsrecht (JMG), 2023, Vol 8, Issue 4, p341
- ISSN
2415-6868
- Publication type
Article
- DOI
10.33196/jmg202304034101