Ethics, Law, and Aging Review, Volume 10: Decision-Making Capacity and Older Persons

by Marshall B. Kapp JD, MPH (Editor)

Overview

Although the topic of decision making capacity and older persons has been discussed in the literature, there still is much to be learned about it theoretically and practically. Experts continue to disagree about which standards are important for assessing decision making capacity. Questions such as: ìWhen should a capacity assessment be done on an older person and by whom?î are covered by the editors.

Topics included in this volume are the application of an original framework for ethical decision making in long term care; an elder's capacity to decide to remain living alone in the community; the quest for helpful standardized instruments for evaluating decision making capacity; and end-of-life liability issues.

Product Details

ISBN-13:	9780826116390
Publisher:	Springer Publishing Company
Publication date:	12/06/2004
Series:	Ethics, Law, and Aging Review
Sold by:	Barnes & Noble
Format:	eBook
Pages:	152
File size:	2 MB

About the Author

Marshall B. Kapp, JD, MPH, FCLM, is a faculty member in the School of Medicine at Wright State University, Dayton, Ohio, where he is the Frederick A. White Distinguished Service Professor in the Departments of Community Health and Psychiatry and Director of the WSU Office of Geriatric Medicine and Gerontology. He holds an adjunct faculty appointment at the University of Dayton School of Law.

Read an Excerpt

chapter

Table of Contents

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Contributors
Acknowledgments
Introduction
Part I: Decision-Making Capacity and Older Persons

1. Commitment, Relationship, Voice: Cornerstones for an Ethics of Long-Term Care, M. Mathes, J. Reifsnyder, and M. Gibney
2. The Capacity to Decide to Remain Living in the Community, L.M. Cooney Jr. and J.M. Keyes
3. Hopes and Cautions for Instrument-Based Evaluation of Consent Capacity: Results of a Construct Validity Study of Three Instruments, J. Moye, M.J. Karel, A.R. Azar, and R.J. Gurrera
4. Competency in Parkinsonís Disease with Dementia, D.C. Marson and M. Dymek
5. Decisional Capacity in Theory and Practice: Legal Process Versus ìBumbling Through,î M.B. Kapp

Part II: Independent Articles

6. End-of-Life Liability Issues, S. Selkin
7. The Work Versus Eldercare Dilemma and the Law: An Israeli Example, I. Doron and G. Linchitz

Book Reviews
Books Received
Index

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Editorial Reviews

3 Stars from Doody

Reviewer: David O. Staats, MD (University of Oklahoma Health Sciences Center)
Description: The papers in this volume 10 of Ethics, Law, and Aging Review center around the topic of decision-making capacity in older persons.
Purpose: The purpose is to summarize the difficulties in the area of decision-making and older persons. What are capacity and competence? Who measures these and how? How do these assessments fit into the clinical picture and how do they interface with the legal system? These are all urgent questions to consider.
Audience: The audience is medical ethicists, geriatricians, gerontologists, specialists in elder law, guardians, law students, medical student, and postgraduate physicians in training. The authors are all experts in the field, and the book is edited by a widely-regarded leader in the field.
Features: There are five papers in the main section. One describes the fundamental ethics of long-term care. The second describes the capacity to decide to remain living in the community. The third describes instrument-based evaluation of consent capacity. The fourth describes competency issues in patients with Parkinson's disease with dementia. The fifth reviews decisional capacity in theory and practice, contrasting the legal system with "bumbling through."
Assessment: This is a wonderful contribution to the field, describing the manifold difficulties around decision-making in older persons. There are real differences between thinking in the abstract and real world tension about treating a gangrenous foot in an incapacitated older person. This book moves towards these areas in useful ways. The paper on when not to be home alone also underscores that a blind commitment to autonomy in cases where the person is clearly incapable of decision-making is incorrect. Eventually we will face the subjective nature of the truth — that fear and pain make us say "no" when our most rational thoughts would say "yes."

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