Competency and Consent to Treatment

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Abstract
To the Editor.— Professor Drane's article, "Competency to Give an Informed Consent: A Model for Making Clinical Assessments,"1offers a notable attempt to simplify the process of obtaining informed consent for medical care. Unfortunately, his suggestion of a "sliding standard" for competency raises serious ethical questions that undermine the value of his scheme. Standard 1 is intended to apply to those situations where the medical procedure is "not dangerous and objectively in the patient's best interest." In such cases the least stringent test for competency holds. Informed consent is considereed to have been given "as long as the patient is aware of what is going on." Whenever the illness is chronic or the proposed treatment more dangerous, then standard 2 is in effect. In these circumstances, competency to give consent exists if the patient is able to understand the risks and outcomes and is able to choose an alternative

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