Free and informed consent is one of the most widespread and morally important practices of modern health care; competence to consent is its cornerstone. In this book, Becky Cox White provides a concise introduction to the key practical, philosophical, and moral issues involved in competence to consent.

The goals of informed consent, respect for patient autonomy and provision of beneficent care, cannot be met without a competent patient. Thus determining a patient's competence is the critical first step to informed consent. Determining competence depends on defining it, yet surprisingly, no widely accepted definition of competence exists. White identifies nine capacities that patients must exhibit to be competent. She approaches the problem from the task-oriented nature of decision making and focuses on the problems of defining competence within clinical practice. Her proposed definition is based on understanding competence as occurring in a special rather than a general context; as occurring in degrees rather than at a precise threshold; as independent of consequential appeals; and as incorporating affective as well as cognitive capacities.

Combining both an ethical overview and practical guidelines, this book will be of value to health care professionals, bioethicists, and lawyers.

An examination of how novice psychiatrists come to understand the workings of the mind—and the nature of medical expertise—as they are trained in psychotherapy.
 
While many medical professionals can physically examine the body to identify and understand its troubles—a cardiologist can take a scan of the heart, an endocrinologist can measure hormone levels, an oncologist can locate a tumor—psychiatrists have a much harder time unlocking the inner workings of the brain or its metaphysical counterpart, the mind.  

In From Skepticism to Competence, sociologist Mariana Craciun delves into the radical uncertainty of psychiatric work by following medical residents in the field as they learn about psychotherapeutic methods. Most are skeptical at the start. While they are well equipped to treat brain diseases through prescription drugs, they must set their expectations aside and learn how to navigate their patients’ minds. Their instructors, experienced psychotherapists, help the budding psychiatrists navigate this new professional terrain by revealing the inner workings of talk and behavioral interventions and stressing their utility in a world dominated by pharmaceutical treatments. In the process, the residents examine their own doctoring assumptions and develop new competencies in psychotherapy. Exploring the world of contemporary psychiatric training, Craciun illuminates novice physicians’ struggles to understand the nature and meaning of mental illness and, with it, their own growing medical expertise.