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Doody's Review ServiceReviewer: Douglas E. Tucker, MD (Rush University Medical Center)
Description: This is a practical, clinician-oriented guide to the assessment of competence to consent to treatment.
Purpose: Its purpose is to provide some clarity and guidelines for caregivers in a complex and confusing area, in which the stakes can be enormous (often life-and-death) but the standards to be applied are often too abstract and inconsistent to be of much help. This book thus serves an important clinical need, and it meets its objective admirably.
Audience: As stated in the title, this book was written for the broad group of physicians and other health professionals, but it will be particularly valuable for those working "in the trenches" in critical care, and geriatric and mental health settings. Both authors are well known and respected authorities in forensic mental health, and have written extensively on the capacity to make treatment decisions.
Features: The book is relatively small and short, and is not illustrated except for a half-dozen tables and a data collection form. It has only 37 references, but this is a deliberately succinct and carefully chosen list of pertinent, clinically useful sources. The appendix contains the format, procedure, and data recording form for the MacCAT-T (MacArthur Competence Assessment Tool-Treatment), a semistructured interview instrument developed by the authors and designed to systematically elicit and organize information about decision-making abilities.
Assessment: This is a very practical and useful book for any clinician who provides treatment to patients for whom competence to consent is an issue. It is quite user-friendly, with convenient chapter summaries and many illustrative clinical vignettes. It will be more helpful to the busy practitioner facing real life treatment dilemmas than to the ivory tower academic. It should be made available in medical school and hospital libraries, although many individuals will wish to purchase it (particularly if a less expensive softcover version is produced).