Reliability of clinical judgment of patients’ competency to give informed consent: A case vignette study
Open accessAbstract
The competency of psychiatric patients to give informed consent is important in respecting patients' decisions as well as protecting patients from undue exploitation. A total of 176 members of the Japanese Society of Psychiatry and Neurology gave a clinical judgment in a questionnaire of competency in five case transcriptions. Their interrater reliability of competency judgment was slight (generalized kappa 0.31). Clinicians' global judgment of patients' competency was not reliable, but it may be improved by the use of a structured interview.
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Studies have shown physicians frequently disagree on the competency of psychiatric patients who request assisted death - inter-rater reliability of capacity judgments by clinicians without the aid of standardized assessments is low, and modest evidence suggests clinicians tend to overestimate capacity.
“Studies have shown physicians frequently disagree on the competency of psychiatric patients who request assisted death — inter-rater reliability of capacity judgments by clinicians without the aid of standardized assessments is low, and modest evidence suggests clinicians tend to overestimate capacity (6, 47–50).”
From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [47]
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Self-citation
- Authors
- Kitamura, T., & Kitamura, F.
- Affiliations
- National Center of Neurology and Psychiatry (JP)
- ORCID
- Kitamura, Toshinori
- Venue
- Psychiatry and Clinical Neurosciences
- Publisher
- Wiley
- Published
- 2000-04
- Volume
- 54
- Issue
- 2
- Pages
- 245-247
- ISSN
- 1323-1316 (ISSN-L)
- 1440-1819
- OpenAlex
- W2101731365
- Cited by
- 30
- References
- 10
- Citations by year
- 2024: 2 · 2023: 1 · 2021: 4 · 2020: 3 · 2018: 3 · 2013: 4 · 2012: 2
- FWCI
- 1.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatry and Clinical Neurosciences (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Funders
- Pfizer
- Pfizer Health Research Foundation
- Japan Science Society
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Keywords
- informed consent, decision-making capacity, competency assessment, psychiatric patients, inter-rater reliability, clinical judgment, structured interviews, case vignettes
- MeSH terms
- Adult, Aged, Mental Disorders, Electroconvulsive Therapy, Expert Testimony, Female, Humans, Informed Consent, Male, Middle Aged, Observer Variation, Mental Competency
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