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The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) is the product of an 8-year study of patients' capacities to make treatment decisions. It is a semi-structured interview that assists clinicians in assessing a patient's competence to consent to treatment. The process provides a patient with information about their medical/psychiatric condition, the type of treatment being recommended, its risks and benefits, as well as other possible treatments and their probable consequences. During this process, the MacCAT-T prompts the clinician to ask questions that assess the patient's understanding, appreciation, and reasoning regarding treatment decisions.The MacCAT-T Manual is a large-format, examiner-friendly field manual for conducting actual competency assessments. The MacCAT-T Record Form is well designed for recording, rating, and summarizing patient responses. The training videotape, Administering the MacCAT-T, demonstrates an actual administration of the test with discussion, comments, and annotations by Drs. Grisso and Appelbaum.The book, Assessing Competence to Consent to Treatment, describes the place of competence in the doctrine of informed consent, analyzes the elements of decision making, and shows how assessments of competence to consent to treatment can be conducted within varied general medical and psychiatric treatment settings. Includes numerous case studies.
The MacCAT-CR provides a structured format for capacity assessment that is adaptable to the particulars of any given research project. With the introduction of the MacCAT-CR, researchers enrolling human participants in their studieshave available for the first time a reliable and valid means of assessing their potential subject's capacity to consent to participation. The MacCAT-CR can typically be administered in 15-20 minutes. Beginning with project-specific disclosures to potential participants, the MacCAT-CR measures the four generally accepted components of decision-making competence: understanding, appreciation, reasoning, and the ability to express a choice. Quantification of subjects' responses permits comparisons across subjects and subject groups, and allows the MacCAT-CR to be used for not only for screening individual participants but also for conducting research on the characteristics of subject populations and for assessing the effectiveness of interventions designed to increase subjects' capacities.
This is a concise guidebook to the assessment of patients' capacities to consent to treatment. It will help clinicians focus on the abilities that are relevant to legal definitions of competence to consent to medical and psychological treatment. With excellent case vignettes, the authors show how the interview process is carried out and offer strategies for responding to patients with limited capacities.
This book offers a conceptual model for understanding the nature of legal competencies. The model is interpreted to assist mental health professionals in designing and performing assessments for legal competencies defined in criminal and civil law, and to guide research that will improve the practice of evaluations for legal competencies. A special feature is the book's evaluative review of specialized forensic assessment instruments for each of several legal competencies. Three-fourths of the 37 instruments reviewed in this second edition are new.
While coordinating the University of Groningen’s Honours College Winterschool/Atelier entitled Children's Rights in Health Care, the need to publish the contributions to this program was generally expressed and confirmed by its participants. The Winterschool/Atelier, successfully organized in recent years, has dealt with many issues concerning the legal position of minor persons – born and unborn – in the context of health care, especially pediatric care. These issues involve matters concerning pediatric treatment, preventive care and predictive medicine, medical research involving children, incompetence and child autonomy, a child’s psychological development, parental responsibility and representation, protective judicial measures, child migration issues, children’s health rights enforcement as well as children’s health interest monitoring and promotion. During the program, leading experts in the fields of law, ethics, medicine, biology, psychology and institutions such as the Dutch Child & Hospital Foundation, the Child Protection Board, Save the Children, and UNICEF shared their views on normative standards, practical experiences, significant developments, challenging ideas, silent dreams and inevitable realities. As a result, the Children's Rights in Health Care program provided opportunities for a profound dialogue between Honours College students and lecturing scholars on a wide range of topics involving children’s health care interests. This volume contains several analyses of health rights issues related to children. The various chapters provide an overview of this captivating area and may be of special interest to lawyers, health care professionals, ethicists, psychologists, judicial institutions, policy makers, interest groups, students and all others who are concerned with the children’s rights perspective on health care.
Adjudicative competence remains an important topic of research and practice in psychology and law. In the five sections of Adjudicative Competence: The MacArthur Studies, the authors present not only a summary of the research of the MacArthur studies on competence but also an examination of the underlying theoretical work of Professor Richard Bonnie. It is the first publication to encapsulate the scope and significance of both the studies themselves and Bonnie's contributions. There is no other source available that addresses this range of topics. Given its breadth and scope, this book will be a "must have" for forensic mental health professionals, an important volume for lawyers, and a vital academic reference work.
Antipsychotic medications are a key treatment for schizophrenia and sales of antipsychotic drugs approach $20 billion per year, with fierce marketing between the makers of the drugs. The U.S. National Institute of Mental Health sponsored the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) project to provide independent information about the comparative effectiveness of medications. CATIE was the largest, longest and most comprehensive study of schizophrenia to date. Conducted under rigorous double-blind conditions, Antipsychotic Trials in Schizophrenia presents the definitive archival results of this landmark study. The core of the book consists of chapters focused on specific outcomes that set the CATIE findings in a wider context. Also included are chapters on the design, statistical analyses and implications for researchers, clinicians and policy makers. Psychiatrists, psychiatric researchers, mental health policy makers and those working in pharmaceutical companies will all find this to be essential reading.
Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.
This textbook, one of the first, provides a comprehensive review of the relationship between psychiatry and legal medicine in the older population. Sections reviewing evaluation, civil and criminal topics, and numerous other areas such as risk management, will help physicians, attorneys, and other professionals in their work with the elderly.