Autonomy: Decision-Making Competency

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Autonomy is the right to self-determination, independence, and freedom. Autonomy expresses the concept that professionals have a duty to treat the person according to the person's desires, within the bounds of accepted treatment, and to protect the individual's confidentiality.

Justice is the obligation to be fair to all people.

Beneficence requires that health care providers do good for individuals under their care by understanding the individual from a holistic perspective that includes the individual's beliefs, feelings, and wishes as well as those of the individual's family and significant others.

Nonmaleficence is the requirement that health care providers do no harm to their patients and that they protect their patients from harm.

In making decisions
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Lynch defined decision-making capacity as the ability to understand the nature and consequences of different options, to make choices among those options, and to communicate that choice. Decision-making capacity is required in order to give informed consent. Such capacity may fluctuate over time, given the state of health of the individual as well as the particular issue.

Another issue related to brain function and health is the notion of competency. Competency is defined legally and determines if an individual is fit and qualified to give testimony or executive a legal document. In the United States, the law presumes all adults are competent and have decision-making capacities to make health decisions unless deemed otherwise in court. Lynch discussed ethical issues within the legal system about the capacity of a vulnerable adult to testify in an elder abuse case. She noted that a lack of competency could be used as a defense litigation strategy to preclude testimony from victims or witnesses of