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A sliding-scale model for assessing patient competency to consent to treatments is proposed. The least stringent standard, to be applied the case of safe and effective treatments, assumes a valid consent if the is aware of what is happening and assents to the rational expectations the physician. The second standard, applicable in the case of less certain, requires that the patient understand the treatment options and the capacity to choose or reject a treatment based on a weighing of risks benefits. The third and most stringent standard, reserved for very treatments, bases competence to consent on an appreciation of the of the medical information for the patient's life and on an to state the reasons for the decision in terms of the medical issues the patient's personal values. (KIE abstract)
James F. Drane (Mon,) studied this question.