One of the most challenging tasks facing clinicians today is the assessment of patients' capacities to consent to treatment. The protection of a patient's right to decide, as well as the protection of incompetent patients from the potential harm of their decisions, rests largely on clinicians' abilities to judge patients' capacities to decide what treatment they will receive. However, confusing laws and the complicated ethical issues surrounding the concept of competence to consent have made the process of competence assessment intimidating for many clinicians. Health professionals--physicians, medical students, residents, nurses, and mental health practitioners--have long needed a concise guidebook that translates the issues for practice. That is what this book accomplishes. This volume is the product of an eight-year study of patients' capacities to make treatment decisions--the most comprehensive research of its kind. The authors describe the place of competence in the doctrine of informed consent, analyze the elements of decision-making, and show how assessments of competence to consent to treatment can be conducted within varied general medical and psychiatric treatment settings. The book explains how assessments should be conducted and offers detailed, practice-tested interview guidelines to assist medical practitioners in this task. Numerous case studies illustrate real-life applications of the concepts and methods discussed. Grisso and Appelbaum also explore the often difficult process of making judgments about competence and describe what to do when patients' capacities are limited. A timely, practical handbook relevant to every medical specialty, Assessing Competence to Consent to Treatment will benefit a wide array of medical practitioners--including physicians, medical students, residents, nurses, and other allied health professionals--who need to assess the mental competence of patients in their everyday practice. It will also interest ethicists and moral philosophers, as well as geriatricians and clinical psychologists working with cognitively impaired patients.

Assessing Competence to Consent to Treatment: A Guide for Physicians and Other Health Professionals

Health, Fitness & Dieting

Appelbaum, Paul S.

Grisso, Thomas

Psychology & Counseling

Oxford University Press

The presumed link between mental disorder and violence has been the driving force behind mental health law and policy for centuries. Legislatures, courts, and the public have come to expect that mental health professionals will protect them from violent acts by persons with mental disorders. Yet for three decades research has shown that clinicians' unaided assessments of "dangerousness" are barely better than chance. Rethinking Risk Assessment: The MacArthur Study of Mental Disorder and Violence tells the story of a pioneering investigation that challenges preconceptions about the frequency and nature of violence among persons with mental disorders, and suggests an innovative approach to predicting its occurrence. The authors of this massive project -- the largest ever undertaken on the topic -- demonstrate how clinicians can use a "decision tree" to identify groups of patients at very low and very high risk for violence. This dramatic new finding, and its implications for the every day clinical practice of risk assessment and risk management, is thoroughly described in this remarkable and long-anticipated volume. Taken to heart, its message will change the way clinicians, judges, and others who must deal with persons who are mentally ill and may be violent will do their work.

Rethinking Risk Assessment: The MacArthur Study of Mental Disorder and Violence

Banks, Steven

Monahan, John

Steadman, Henry J.

Silver, Eric

Clark Robbins, Pamela

Mulvey, Edward P.

Roth, Loren H.

In the twenty-first-century world of juvenile justice policy and practice, nearly everyone agrees that one of the most pressing issues facing the nation's juvenile courts is their proper response to delinquent youths with mental disorders. Recent research indicates that about two-thirds of adolescent offenders in juvenile justice facilities meet the criteria for one or more mental disorders. What are the obligations of our juvenile justice system, then, as the caretaker for delinquent youth with such disabilities? How do issues of adolescent development create special challenges in determining the court's proper response to delinquents with special mental health needs? Thomas Grisso considers these questions while offering new information to assist the juvenile justice system in its responses to the needs of our children. Double Jeopardy considers the newest data on the nature of youths' mental disorders—their relationships to delinquency, the values and limits of methods to treat them, and the common patterns of adolescent offending. That information is used to chart a rational course for fulfilling the juvenile justice system's duty—as a custodian of children in need of health care, as a legal system promoting fairness in youth adjudication, and as a protector of public safety—to respond to delinquent youths' mental disorders. Moreover, Double Jeopardy provides a scientific yet practical foundation for lawmakers, judges, attorneys, and mental health care professionals, as well as researchers who must fill the knowledge gaps that limit the juvenile justice system's abilities to meet youths' mental health needs.

Double Jeopardy: Adolescent Offenders with Mental Disorders (Adolescent Development and Legal Policy)

University of Chicago Press

Nearly two-thirds of adolescent offenders currently held in juvenile justice facilities across the United States meet the criteria for one or more mental disorders—a fact that has many parents, healthcare providers, and legislatures wondering about our mental health systems for children. Have these systems failed so badly that we must arrest our children for crimes in order for them to receive help? In Double Jeopardy,leading researcher Thomas Grisso considers the newest data on the nature of mental disorders in youth—examining, for example, their relationship to delinquency, the values and limits of various treatment methods, and common, related patterns of adolescent offending—and then charts a course for practitioners working within today’s juvenile justice system. Grisso carefully evaluates the threefold obligations of the juvenile justice system: as a custodian of children with health needs, a legal system promoting fairness in youth adjudication, and protector of public safety. Double Jeopardy provides a scientific and practical foundation for lawmakers, judges, attorneys, and mental health care professionals, as well as researchers in mental health and adolescent development.

Teen & Young Adult

This book offers a conceptual model for understanding the nature of legal competencies. The model is interpreted to assist mental health professionals in designing and performing assessments for legal competencies defined in criminal and civil law, and to guide research that will improve the practice of evaluations for legal competencies. A special feature is the book's evaluative review of specialized forensic assessment instruments for each of several legal competencies. Three-fourths of the 37 instruments reviewed in this second edition are new.

Evaluating Competencies: Forensic Assessments and Instruments (Perspectives in Law & Psychology, 7)

Mental Health

Springer

This book offers a conceptual model for understanding the nature of legal competencies. The model is interpreted to assist mental health professionals in designing and performing assessments for legal competencies defined in criminal and civil law, and to guide research that will improve the practice of evaluations for legal competencies. A special feature is the book's evaluative review of specialized forensic assessment instruments for each of several legal competencies. Three-fourths of the 37 instruments reviewed in this second edition are new.

Evaluating Competencies: Forensic Assessments and Instruments (Perspectives in Law & Psychology, 16)

Competency to Stand Trial Evaluation: A Manual for Practice

Rules & Procedures

Professional Resource Exchange Inc

The research studies reported in this book were completed between June, 1976 and November, 1979, with a USPHS research grant (MH- 27849) from the Center for Studies of Crime and Delinquency, National Institute of Mental Health. Every phase of the project was an exercise in combining the research methods of psychology with the concerns of law, legal systems, and legal process. Research psychologists will be especially interested in our efforts to apply psychological constructs and research methods to a difficult decision-making problem in law. This report describes in some detail the project's development of experimental measures of psychological condi­ tions related to legal standards and demonstrates the ways in which research design was influenced by concerns of law and the juvenile justice system. Lawyers, judges, and youth advocate groups have already ex­ pressed considerable interest in the implications of the project's results for the formation and modification of juvenile law and procedure. In each chapter, I have attempted to describe carefully the ways in which the empirical research results are applicable to these concerns, and I have tried to specify the limits which must be acknowledged in inter­ preting the results for application in the legal process.

Juveniles’ Waiver of Rights: Legal and Psychological Competence (Perspectives in Law & Psychology)

Criminal Law

Forensic Evaluation of Juveniles

Book by Thomas Grisso, Paul S. Appelbaum

Macarthur Competence Assessment Tool for Treatment (Maccat-T)

Medical Books

Medicine

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