1)Explore the issues of how to determine if a patient is mentally competent to make his or her own decisions, especially in situations where the decisions do not appear to make sense.100words

2)What are the differences between a permanent vegetative state and a coma? How do these differences affect the ethical choices faced by the family and caregivers of the patient? What impacts should the patient’s own wishes have? How would the presence of a living will impact the decision? 150 words

3)Write a 100 word response to :In the hospital setting, patients must be informed by the hospitalist regarding on disease, treatment options, associated risks and benefits, potential for complications, and alternative treatments. Patient feels free to make their own decision. However, it depends on the hospitals to determine whether a patients are mentally competent to make their own decision. In order to come up to determination, a hospitalist needs to know how to assess capacity. Also, hospitalist can use MAcCAT-T as a validated clinical tool to help to evaluate patient’s capacity. This is an instrument assesses patient’s competence to make treatment decision by examine their capacities in four components such as understanding information relevant to their condition and the recommended treatment, reasoning about the potential risks and benefits of their choices, appreciating the nature of their situation and the consequences of the choices, and expressing a choice.

For example, the patient needs to be able to express a treatment choice, and this decision needs to be steady enough for the treatment to be applied. When a patient plan to change his or her decision, this would not bring a patient’s capacity into question, as long as the patient is able to explain the logic reasons behind the change. But if repeated changes back and forth in the decision making, the patient’s capacity should be questioned.

In short, when patient’s capacity is in question, a hospitalist need to rationalize case-by case of based on the four components of capacity which can help them to determine whether the patient has capacity competence.

4)Write a 100 word response to: A patients ability to make decision about what he/she wants in relevant to their health condition si very important. Competency means having sufficient ability to make a decision. Sometimes the competency can be in a task specific way which means maybe  the law will allow them to make a decision in a will but will allow them to take a decision on their treatment options. In a scenario where a patient is not able to make a decision it is initially evaluated by the physician. Capacity refers to an assessment of the individual’s psychological abilities to form rational decisions, specifically the individual’s ability to understand, appreciate, and manipulate information and form rational decisions. Usually this is done by the psychiatric physicians. Appreciation for the seriousness of the medical condition and the ability to weigh risks and benefits are essential components to the capacity assessment

Some of the components which helps determine thae patients ability are:

Ability to evidence a choice

Ability to understand relevant information

Ability to manipulate information rationally

Ability to understand the medical condition and the prognosis.

Ability to understand the consequences if traetmenst is not administered.

Ability to understand the risk and potential benefits.

Ability to understand and evaluate other alternatives.

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