PHLB09H3 Chapter Notes - Chapter 2: Advance Healthcare Directive, Relational Theory, Child Protection
Document Summary
Medical decision making may be more complex than just letting an autonomous patient decide what to do. Factors to think of: physical, cognitive, psychological, social, and cultural. So if respect for autonomy is to be met, it becomes necessary to determine the patient"s competence to make the decision. Competence can vary (time of day, situation, presence of drugs/alcohol, head injury, etc. ), assessing competence must be an ongoing process health care providers (hcp) needs to be aware of changes in competence. Needs to know the patient well enough to speak of their behalf and make substituted judgement (decision that hcp or surrogate makes, based on what the patient would want if they were to make the decision themselves) a. If they don"t know what the patient would have wanted, the surrogate must work with the hcp to make a best-interest judgement. b.