Do clinicians follow a risk-sensitive model of capacity-determination? An experimental video survey.
The authors asked whether clinicians use a risk-sensitive model for decisional-capacity determinations; that is, whether a higher degree of capacity was required in higher-risk situations. The respondents were randomly assigned to view a videotaped "capacity" interview of a medication-randomized clinical trial scenario (N=52) or a neurosurgical clinical trial scenario (N=47). A significant scenario effect was mediated by the respondents' perception of scenario-specific risk. Respondents showed considerable disagreement within each scenario that was not explained by clinician-specific factors. Thus, clinicians, in fact, use the normative risk-sensitive model for capacity, but there remains considerable unexplained variability in their judgments.
Kim
Scott Y H
SY
Dept. of Psychiatry, the Bioethics Program, and the Center for Behavioral and Decision Sciences in Medicine, Univ. of Michigan, MI, USA. scottkim@umich.edu
Caine
Eric D
ED
Swan
Jeffrey G
JG
Appelbaum
Paul S
PS
D001076:Aptitude; D002983:Clinical Competence; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011611:Psychosomatic Medicine; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D014743:Videotape Recording