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25 - Bioethics 3/25 13:55:00 END-OF-LIFE MATTERS Ethical...

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Bioethics 3/25 25/03/2008 13:55:00 END-OF-LIFE MATTERS: Ethical issues at the end of life Who should make decisions about these things? decision makers On what basis should these decisions be made? decision standards When does a patient have the ability to make his or her own decisions? DECISIONAL CAPACITY : the clinical correlate of the ethical/philosophical concept of self-determination/autonomy If a person lacks decisional capacity, then that person’s decisions do not have to be respected as an expression of autonomy. Typically we presume that adults have decisional capacity to make any and all decisions regarding their lives UNLESS there is some compelling reason to think they lack that capacity then we assume that they do have it. It is our burden to prove that they do lack it. Decisional capacity involves certain elements. Decisional capacity capacity to decide about X . The notion of decisional capacity is always relative to a specific decision . As the X increases in severity, one’s capability to handle the decision will vary.
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