[Capacity to consent to treatment in dementia patients : Interdisciplinary perspectives]. / Einwilligungsfähigkeit bei Demenz : Interdisziplinäre Perspektiven.

ABSTRACT

BACKGROUND: Currently, there are no concrete, evidence-based default procedures to adequately assess the capacity to consent to medical treatment. This explains why different raters use individual heuristics, differing both within and between disciplines. The lack of a procedure that is standardized, validated, and equally accepted across disciplines to assess the capacity to consent to treatment has led to an uncertainty in legal and medical practice regarding appropriate action and decision making. Due to the dramatic increase in the number of patients with dementia and multimorbidity, who have to regularly consent to various medical treatments but whose capacity to consent is hindered due to cognitive impairments, this topic is particularly timely. OBJECTIVE: The present study aims to investigate how experts of different disciplines (law, medicine, ethics) assess the capacity to consent on the basis of a case study involving a patient with dementia. MATERIALS AND METHODS: The judgements and judgement criteria of 41 experts from various disciplines were surveyed via a self-administered questionnaire that was distributed via postal mail. RESULTS: The results show that experts from various disciplines come to different conclusions regarding the capacity of the patient with dementia to consent. CONCLUSION: These observations lead to the conclusion that there is an urgent need for an interdisciplinary guideline for the assessment of the capacity to consent to treatment, for interdisciplinary training, and for more interdisciplinary exchange in the assessment process.