metricas
covid
Buscar en
Revista Colombiana de Psiquiatría
Toda la web
Inicio Revista Colombiana de Psiquiatría Del principio de beneficencia al principio de autonomía: aproximación a la eva...
Journal Information
Vol. 41. Issue 2.
Pages 395-407 (June 2012)
Share
Share
Download PDF
More article options
Vol. 41. Issue 2.
Pages 395-407 (June 2012)
Epistemología filosofía de la mente y bioética
Full text access
Del principio de beneficencia al principio de autonomía: aproximación a la evaluación de la competencia mental de los pacientes en el hospital general
From the Principle of Beneficence to the Principle of Autonomy. Assessment of Patients' Mental Competency in the General Hospital
Visits
1338
Restrepo B. Diana1,
Corresponding author
dianarestrepobernal@gmail.com

Correspondencia: Diana Restrepo B., Hospital Universitario San Vicente Fundación, Calle 64, carrera 51D, Medellín, Colombia
, Cardeño C. Carlos1, Duque G. Marle2, Jaramillo Santiago3
1 Médica(o) psiquiatra de Enlace, Hospital Universitario San Vicente Fundación, Medellín, Colombia
2 Médico residente de Psiquiatría de III año, Universidad de Antioquia, Medellín, Colombia
3 Médico psiquiatra, Universidad de Antioquia, Medellín, Colombia
This item has received
Article information
Resumen
Introducción

Rechazar un acto médico es un ejercicio válido dentro del derecho a la autonomía que tiene todo paciente. Desde el punto de vista legal, la autonomía se fundamenta en el derecho a la intimidad. En los últimos decenios, el derecho legal a la autodeterminación se ha ampliado progresivamente y hoy los pacientes en pleno uso de sus facultades mentales tienen el derecho moral y legal de tomar sus propias decisiones y estas tienen prioridad sobre las decisiones del médico y la familia.

Objetivo

Analizar el papel de los psiquiatras de enlace para evaluar la competencia mental de estos pacientes.

Discusión y Conclusiones

La evaluación de la capacidad de un paciente para decidir y autodeterminarse es un problema clínico frecuente en los hospitales generales. La evaluación de estos pacientes exige un conocimiento apropiado de los fundamentos filosóficos, éticos y legales que guían el tratamiento apropiado de estos complejos problemas clínicos.

Palabras clave:
Capacidad para decidir
consentimiento informado
autonomía
psiquiatría de enlace
Abstract
Introduction

Refusing a medical procedure is a valid way of exercising every patient's right to autonomy. From the legal point of view, autonomy is based on the right to privacy. In recent decades the legal right to self-determination has gradually expanded and today patients in full possession of their mental faculties, have the moral and legal right to make their own decisions and these decisions take precedence over physician and family. Often liaison psychiatrists are called in to assess the mental competence of patients in the general hospital.

Objective

To determine the psychiatrist's role in evaluating these patients.

Discussion and Conclusions

The assessment of a patient's ability to decide and self-determine is a common clinical problem in general hospitals. Evaluation of these patients requires a proper understanding of the philosophical, ethical, and legal issues that guide the appropriate treatment of these complex clinical problems.

Key words:
Capacity to decide
informed consent
autonomy
liaison psychiatry
Full text is only aviable in PDF
Referencias
[1]
MG Farnsworth.
Competency evaluations in a general hospital.
Psychosomatics, 31 (1990), pp. 60-66
[2]
JB Jourdan, L Glickman.
Reasons for requests for evaluation of competency in a municipal general hospital.
Psychosomatics, 32 (1991), pp. 413-416
[3]
DC Marson, B McInturff, L Hawkins, et al.
Consistency of physician judgments of capacity to consent in mild Alzheimer's disease.
J Am Geriatr Soc, 45 (1997), pp. 453-457
[4]
V Raymont, W Bingley, A Buchanan, et al.
Prevalence of mental incapacity in medical inpatients and associated risk factors: cross-sectional study.
Lancet, 364 (2004), pp. 1421-1427
[5]
LJ Fitten, MS Waite.
Impact of medical hospitalization on treatment decision-making capacity in the elderly.
Arch Intern Med, 150 (1990), pp. 1717-1721
[6]
LJ Fitten, R Lusky, C Hamann.
Assessing treatment decision-making capacity in elderly nursing home residents.
J Am Geriatr Soc, 38 (1990), pp. 1097-1104
[7]
LM Cohen, JD McCue, GM Green.
Do clinical and formal assessments of the capacity of patients in the intensive care unit to make decisions agree?.
Arch Intern Med, 153 (1993), pp. 2481-2485
[8]
RR Faden, RL Beauchamp.
A history and theory of informed consent, pp. 235-268
[9]
Moral Character.
Principles of biomedical ethics, 5th ed., pp. 26-56
[10]
D Arcila.
Aspectos jurídicos del consentimiento informado en Colombia.
El consentimiento informado, pp. 40-43
[11]
Respect for autonomy.
Principles of biomedical ethics, 5th ed., pp. 57-112
[13]
LB Dunn, MA Nowrangi, BW Palmer, et al.
Assessing decisional capacity for clinical research or treatment: a review of instruments.
Am J Psychiatry, 163 (2006), pp. 1323-1334
[14]
JF Drane.
Competency to give an informed consent: a model for making clinical assessments.
JAMA, 252 (1984), pp. 925-927
[15]
MB Kapp, D Mossman.
Measuring decisional capacity: cautions of the construction of a “capacimeter”.
Psychol Public Policy Law, 2 (1996), pp. 73-95
[16]
T Grisso, PS Applebaum, C Hill-Fotouhi.
The macCAT-T: a clinical tool to assess patients's capacities to make treatment decisions.
Psychiatr Serv, 48 (1997), pp. 1415-1419
[17]
SYH Kim, JHT Karlawish, ED Caine.
Current state of research on decision-making competence of cognitively impaired elderly persons.
Am J Geriatr Psychiatry, 10 (2002), pp. 151-165
[18]
SR White-Bateman, HC Schumacher, RL Sacco, et al.
Consent for thrombolysis in acute stroke: review and future directions.
Arch Neurol, 64 (2007), pp. 85-92
[19]
F Kitamura, A Tomoda, K Tsulcada.
Method for assessment of competency to consent in the mentally ill. Rational, developmentet, and comparison with the medically ill.
International Journal of Law and Psychiatry, 21 (1998), pp. 223-244
[20]
J Vollmann, A Bauer, H Danker-Hoipfe, et al.
Competence of mentally ill patients: a comparative empirical study.
Psychol Med, 33 (2003), pp. 1463-1471
[21]
R Cairns, C Maddock, A Buchanan, et al.
Reability of mental capacity assessments in psychiatric in-patients.
Br J Psychiatry, 187 (2005), pp. 372-378

Conflictos de interés: Los autores manifiestan que no tienen conflictos de interés en este artículo.

Copyright © 2012. Asociación Colombiana de Psiquiatría
Download PDF
Article options