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Institute of Biomedical Ethics and History of Medicine (IBME) Psychiatric and Psychotherapy Ethics (PAPE) Research Group

Decision-making capacity / Decisional competence / Capacity for self-determination

decision making

Short description

Our research in this area consists of different research projects dealing with the concept, ethical and legal issues as well as the clinical evaluation of decision-making capacity as one of the key criteria for the patients’ self-determination in the process of informed consent and shared decision making.

Collaboratoring universities - persons

  • Columbia University, New York - Prof. Paul S. Appelbaum, MD
  • Harvard University, Boston - Christine Mitchell, RN, MS, MTS, FAAN
  • Ruhr-University Bochum, Germany - Dr. med. Jakov Gather, MA; Dr. Matthé Scholten, PhD
  • University of Siegen, Germany - Prof. Julia Haberstroh, PhD
  • University of St. Gallen, Switzerland - Prof. Daniel Hürlimann, JD
     

Involved PAPE group researchers

Nikola Biller-Andorno, Charlotte Wetterauer, Tobias Zürcher, Manuel Trachsel

Former member of the group: Helena Hermann
 

Medical-ethical guidelines of the Swiss Academy of Medical Sciences (SAMS) and U-DOC

Members of the PAPE research group have been involved in the development of the medical-ethical guidelines for “Decision-making capacity” of the Swiss Academy of Medical Sciences (SAMS) and the assessment tool U-DOC.

Funding

Our work in this area from 2012 to 2017 was part of the “Incapacity at the End of Life and Its Assessment in Switzerland” study funded within the National Research Program NRP 67 End of Life of the Swiss National Science Foundation SNF (SNF-Grant 406740_139294).

Publications

  • Trachsel, M., & Appelbaum, P. S. (2020). A narrative coherence standard for the evaluation of decisional capacity: turning back the clock. AJOB Neuroscience, 11(1), 1-3.
     
  • Hermann, H., Feuz, M., Trachsel, M., & Biller-Andorno, N. (2020). Decision-making capacity: From testing to evaluation. Medicine, Healthcare, and Philosophy. https://doi.org/10.1007/s11019-019-09930-6
     
  • Poppe, C., Elger, B. E., Wangmo, T., & Trachsel, M. (2020). Evaluation of decision-making capacity in patients with dementia: Challenges and recommendations from a secondary analysis of qualitative interviews. BMC Medical Ethics. 21:55. doi.org/10.1186/s12910-020-00498-y
     
  • Wood, S., Bally, K., Cabane, C., Fassbind, P., Jox, R. J., Leyhe, T., Monsch, A., & Trachsel, M. (2020). Decision-making capacity evaluations: The role of neuropsychological assessment from a multidisciplinary perspective. BMC Geriatrics, 20, 535.

  • Zürcher, T., Elger, B., & Trachsel, M. (2019). The notion of free will and its ethical relevance for decision-making capacity. BMC Medical Ethics, 19(20), 1–10.
     
  • Biller-Andorno, N., Bischoff, T., […] & Trachsel, M. (2019). Medical-ethical guidelines: Assessment of capacity in medical practice. Swiss Medical Weekly, 149:w20030.
     
  • Haberstroh, J., Gather, J., & Trachsel, M. (2018). Informed consent, capacity assessment, and advance planning in treatment and research. GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry, 31(2), 55–56.
     
  • Iseli, L., Wangmo, T., Hermann, H., Trachsel, M., & Elger, B. S. (2018). Challenges facing clinicians when evaluating capacity: A qualitative study. GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry, 31(2), 67–75.
     
  • Shaw, D., Trachsel, M., & Elger, B. (2018). Assessment of decision-making capacity in patients requesting assisted suicide. The British Journal of Psychiatry, 213, (1), 393–395, 2018.
     
  • Novosel, D., Marušić, S. L., Biller-Andorno, N., & Trachsel, M. (2018). Medical decision-making capacity: knowledge, attitudes, and clinical evaluation practices of primary care physicians and psychiatrists in Croatia. GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry, 31(2), 57–65.
     
  • Hermann, H., Trachsel, M., & Biller-Andorno, N. (2017). Shedding light on implicit processes and the inherent “vagueness” of decision-making capacity. Philosophy, Psychiatry & Psychology, 24(4), 333-335.
     
  • Hermann, H., Trachsel, M., & Biller-Andorno, N. (2017). Accounting for intuition in decision-making capacity: Rethinking the reasoning standard? Philosophy, Psychiatry & Psychology, 24(4), 313-324.
     
  • Hürlimann, D., & Trachsel, M. (2017). Ist die fürsorgerische Unterbringung von Urteilsfähigen zulässig? Swiss Medical Forum, 17(9), 214-216.
     
  • Hermann, H., Trachsel, M., & Biller-Andorno, N. (2016). Einwilligungsfähigkeit: Inhärente Fähigkeit oder ethisches Urteil? [Decision-making capacity: Intrinsic ability or ethical judgment?] Ethik in der Medizin, 28(2), 107–120.
     
  • Trachsel, M., & Hürlimann, D. (2016). Urteilsfähigkeit als Voraussetzung für selbstbestimmte Entscheidungen dementer Personen. In I. Bopp-Kistler (Hrsg.). Demenz. Zürich: rüffer & rub.
     
  • Trachsel, M., Hermann, H., & Biller-Andorno, N. (2015). Cognitive fluctuations as a challenge for the assessment of decision-making capacity in patients with dementia. American Journal of Alzheimer’s Disease and Other Dementias, 30(4), 360-363.
     
  • Hürlimann, D., & Trachsel, M. (2015). Urteilsfähigkeit, Zurechnungsfähigkeit und Schuldfähigkeit: Alles Müller, oder was? Swiss Medical Forum, 15(25), 604-606.
     
  • Trachsel, M., Hürlimann, D., Hermann, H., & Biller-Andorno, N. (2015). Umgang mit besonderen Herausforderungen bei der ärztlichen Beurteilung von Urteilsfähigkeit [Handling of particular challenges in the medical assessment of decision-making capacity]. Bioethica Forum. Swiss Journal of Biomedical Ethics, 8(2), 20-24.
     
  • Hermann, H., Trachsel, M., & Biller-Andorno, N. (2015). Physicians’ personal values in determining medical decision-making capacity: A survey study. Journal of Medical Ethics, 41(9), 739-744.
     
  • Hermann, H., Trachsel, M., Mitchell, C, & Biller-Andorno, N. (2014). Medical decision-making capacity: knowledge, attitudes, and assessment practices of physicians in Switzerland. Swiss Medical Weekly, 144:w14039.
     
  • Trachsel, M., Mitchell, C., & Biller-Andorno, N. (2013). Decision-making incapacity at the end of life: conceptual and ethical challenges. Bioethica Forum. Swiss Journal of Biomedical Ethics, 6(1), 26-30.
     

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