title: Competence in chronic mental illness: the relevance of practical wisdom.
abstract: The concept of competence is central to healthcare because informed consent can only be obtained from a competent patient. The standard approach to competence focuses on cognitive abilities. Several authors have challenged this approach by emphasising the role of emotions and values. Combining cognition, emotion and values, we suggest an approach which is based on the notion of practical wisdom. This focuses on knowledge and on determining what is important in a specific situation and finding a balance between various values, which are enacted in an individual's personal life. Our approach is illustrated by two cases of patients with obsessive-compulsive disorder.
authors.affiliation: Department of Medical Humanities, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Guy A M
authors.initials: GAM
authors.lastname: Widdershoven
authors.affiliation: Department of Medical Humanities, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ruissen
authors.affiliation: Department of Psychiatry, GGZ inGeest, Amsterdam, The Netherlands.
authors.forename: Anton J L M
authors.initials: AJLM
authors.lastname: van Balkom
authors.affiliation: Department of Law, Tilburg University, Tilburg, The Netherlands.
authors.forename: Gerben
authors.initials: G
authors.lastname: Meynen
mesh_terms: D003071:Cognition; D003657:Decision Making / Q000941:ethics*; D004644:Emotions / Q000941:ethics*; D028744:Ethics Committees, Research; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000941:ethics*; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000523:psychology* / Q000628:therapy; D026684:Personal Autonomy; D011369:Professional-Patient Relations / Q000941:ethics*; D011570:Psychiatry; D012720:Severity of Illness Index
keywords: Capacity; Clinical Ethics; Competence/incompetence; Psychiatry