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Miriam Kennedy Julieanne Dornan Emer Rutledge Helen O'Neill Harry G. Kennedy 《International journal of law and psychiatry》2009,32(6):369-376
BackgroundCase law across jurisdictions requires ever more complete disclosure of material facts when obtaining consent to treatment.AimsTo determine whether giving extra information impairs the mental capacity to make decisions about treatment.MethodThe MacCAT-T, MacCAT-FP, PANSS and GAF were administered to 88 detained forensic patients with psychosis. Two positive and two negative facts were given about each of two anti-psychotic drugs, and no treatment (twelve items). A choice was elicited. The criterion for incompetence was inability to express a choice. Two extra positive and two extra negative facts about each of the three options were given (twelve extra items) and a choice was again elicited, while repeating the MacCAT-T.ResultsGiving extra information led to a decline in the total score on the MacCAT-T. Twenty one were initially unable to make a choice (24%). After additional information, 33 were incapable (37.5%, Chi-squared p < 0.001). Those initially incapable had the lowest scores on all measures of functional capacity and GAF, with highest scores for symptoms. Those able to choose a treatment option had the highest levels of function and least symptoms. Those who became incapable had intermediate scores.ConclusionsGiving extra information made an extra 15% unable to choose. Clinical judgement must be exercised concerning the amount of information disclosed. Deciding what is material to the individual is arbitrary when so few items of information can be processed. Greater use of guardianship and independent second opinions is recommended. 相似文献
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Steven W. Mosher Norma Diamond Dennis Doverspike Donald C. Simmons Philip Siegelman Joseph Adelson Peter L. Berger David Mechanic Peter Van Ness Harry Schwartz Irving Louis Horowitz Thomas Kochman David Willems Mauricio Schoijet Stanley Rothman Asoke Basu Seymour Martin Lipset Richard Rose 《Society》1984,21(3):4-12
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Harry Taylor 《公共行政管理与发展》1995,15(5):481-494
A large component of development aid in the past has been in the form of scholarships for officials and managers to attend short and long training programmes in the west. However, it has increasingly been felt that the impact of such programmes is limited, and hence the donor community is placing increased emphasis on ‘projectized’ training programmes, i.e. training that is geared to specific development projects in a particular country. This shift has implications for the nature of the training, the learning processes involved and the roles of trainers. This article explores these issues, firstly reviewing the debate between ‘open’ and ‘projectized’ training, and then going on to report on a case study involving a ‘projectized’ learning event run for the Nigerian Civil Service as part of its Civil Service reform programme. The case study explores the main differences between ‘open’ and ‘projectized’ training, demonstrates some of the potential problems with ‘projectized’ learning and, where appropriate, suggests solutions and offers a number of practical suggestions for trainers to consider for operating in an increasingly ‘projectized’ training scene. 相似文献