| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ALL ISSUES | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Regular Article |
Received November 26, 2001; revised, accepted December 28, 2001. From The Law School, University of Southern California (Ms. Saks), and the Department of Psychiatry, University of California, San Diego, and VA San Diego Healthcare System (Dr. Dunn, Ms. Marshall, Mr. Nayak, Dr. Golshan, Dr. Jeste). Address correspondence to Elyn R. Saks, J.D., The Law School, University of Southern California, University Park, Los Angeles, CA 90089-0071. e-mail: esaks{at}law.usc.edu
Capacity to consent is one of the linchpins of the ethical conduct of clinical care and research, and it needs to be reliably measured. The authors describe the development of a new measure of the "appreciation" component of capacity, the California Scale of Appreciation (CSA), 18 items rated according to the concept of "patently false belief" (a belief that is grossly improbable); 39 patients with schizophrenia or a related psychotic disorder (27 outpatients and 12 inpatients) and 15 normal-comparison subjects participated. Each subject's audiotaped interview was rated by three evaluators. Answers to each item were scored as "capable," "incapable," or "uncertain capacity." Also, each subject was given an overall rating of one of these three categories by each rater. Total scores on the CSA were calculated and correlated with scores on standardized instruments for assessing psychopathology and cognitive impairment. The mean total CSA score was significantly lower in the patients than in the normal-comparison subjects; however, a majority of the patients were found to be fully "capable" on the CSA. The CSA is a potentially useful instrument for measuring the appreciation component of capacity in persons with psychotic disorders. Its generalizability to other patient populations and to other types of protocols needs to be determined.
Key Words: Bioethics • Informed Consent • Assessment Scales
This article has been cited by other articles:
|
|
 |
|
  D. V. Jeste, B. W. Palmer, S. Golshan, L. T. Eyler, L. B. Dunn, T. Meeks, D. Glorioso, I. Fellows, H. Kraemer, and P. S. Appelbaum Multimedia Consent for Research in People With Schizophrenia and Normal Subjects: a Randomized Controlled Trial Schizophr Bull, January 31, 2008; (2008) sbm148v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. S. Appelbaum Assessment of Patients' Competence to Consent to Treatment N. Engl. J. Med., November 1, 2007; 357(18): 1834 - 1840. [Full Text] [PDF]
|
|
|
|
 |
|
 D. OKAI, G. OWEN, H. McGUIRE, S. SINGH, R. CHURCHILL, and M. HOTOPF Mental capacity in psychiatric patients: Systematic review The British Journal of Psychiatry, October 1, 2007; 191(4): 291 - 297. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. V. Jeste, B. W. Palmer, P. S. Appelbaum, S. Golshan, D. Glorioso, L. B. Dunn, K. Kim, T. Meeks, and H. C. Kraemer A New Brief Instrument for Assessing Decisional Capacity for Clinical Research Arch Gen Psychiatry, August 1, 2007; 64(8): 966 - 974. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. T. Eyler, R. K. Olsen, G. V. Nayak, H. Mirzakhanian, G. G. Brown, and D. V. Jeste Brain Response Correlates of Decisional Capacity in Schizophrenia: A Preliminary fMRI Study J Neuropsychiatry Clin Neurosci, May 1, 2007; 19(2): 137 - 144. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Resnick, A. L. Gruber-Baldini, I. Pretzer-Aboff, E. Galik, V. C. Buie, K. Russ, and S. Zimmerman Reliability and Validity of the Evaluation to Sign Consent Measure Gerontologist, February 1, 2007; 47(1): 69 - 77. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Moye and D. C. Marson Assessment of Decision-Making Capacity in Older Adults: An Emerging Area of Practice and Research J. Gerontol. B. Psychol. Sci. Soc. Sci., January 1, 2007; 62(1): P3 - P11. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. S. Srebnik and S. Y. Kim Competency for Creation, Use, and Revocation of Psychiatric Advance Directives J Am Acad Psychiatry Law, December 1, 2006; 34(4): 501 - 510. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. B. Dunn, M. A. Nowrangi, B. W. Palmer, D. V. Jeste, and E. R. Saks Assessing Decisional Capacity for Clinical Research or Treatment: A Review of Instruments Am J Psychiatry, August 1, 2006; 163(8): 1323 - 1334. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. W Palmer and D. V Jeste Relationship of Individual Cognitive Abilities to Specific Components of Decisional Capacity Among Middle-Aged and Older Patients With Schizophrenia Schizophr Bull, January 1, 2006; 32(1): 98 - 106. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. B Dunn, P. J Candilis, and L. W. Roberts Emerging Empirical Evidence on the Ethics of Schizophrenia Research Schizophr Bull, January 1, 2006; 32(1): 47 - 68. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. R Saks, L. B Dunn, and B. W Palmer Meta-Consent in Research on Decisional Capacity: A "Catch-22"? Schizophr Bull, January 1, 2006; 32(1): 42 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. V Jeste, C. A Depp, and B. W Palmer Magnitude of Impairment in Decisional Capacity in People With Schizophrenia Compared to Normal Subjects: An Overview Schizophr Bull, January 1, 2006; 32(1): 121 - 128. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. W. Palmer, L. B. Dunn, P. S. Appelbaum, S. Mudaliar, L. Thal, R. Henry, S. Golshan, and D. V. Jeste Assessment of Capacity to Consent to Research Among Older Persons With Schizophrenia, Alzheimer Disease, or Diabetes Mellitus: Comparison of a 3-Item Questionnaire With a Comprehensive Standardized Capacity Instrument Arch Gen Psychiatry, July 1, 2005; 62(7): 726 - 733. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Y.H. Kim, P. S. Appelbaum, D. V. Jeste, and J. T. Olin Proxy and Surrogate Consent in Geriatric Neuropsychiatric Research: Update and Recommendations Am J Psychiatry, May 1, 2004; 161(5): 797 - 806. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. P. Chopra, D. Weiss, J. L. Stinnett, and D. W. Oslin Treatment-Related Decisional Capacity Am J Geriatr Psychiatry, April 1, 2003; 11(2): 257 - 258. [Full Text] [PDF]
|
|
|
|
|
|
C. F. Reynolds III Advancing Research in Decision-Making Capacity: An Opportunity for Leadership--and an Obligation of Geriatric Psychiatry Am J Geriatr Psychiatry, April 1, 2002; 10(2): 117 - 119. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ALL ISSUES | SEARCH | TABLE OF CONTENTS |
