Cambridge Quarterly of Healthcare Ethics

Special Section: Ethics Consultants and Ethics Consultations

Does Depression Invalidate Competence? Consultants' Ethical, Psychiatric, and Legal Considerations

Ernlè W. D. Younga1, James C. Corbya2 and Rodney Johnsona3

a1 University School of Medicine, Co-director of the Stanford University Center for Biomedical Ethics, and Ethics Consultant to and Chair of the Stanford University Hospital Ethics Committee

a2 University School of Medicine and a psychiatrist in private practice in Santa Cruz, California

a3 University Medical Center and serves on the Stanford University Hospital Ethics Committee

The ethical principle of respect for autonomy has come into its own In American medicine since World War II as equal in importance to the traditional medicomoral principles of nonmaleficence and beneficence. Respect for autonomy provides the ethical underpinning for the patient's right to exercise an informed choice – whether to consent to or to refuse recommended medical treatment. However, an informed choice demands a certain level of competence. Typical criteria for patient competence to accept or to refuse medical treatments Include ability to make a choice and ability to comprehend the nature of the treatment, as well as the risks and benefits of accepting or refusing the treatment.

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