Field of medicine: Psychiatry and medical ethics.

Format: Hardcover book.

Audience: All clinicians, especially those in critical care medicine, geriatrics, and mental health.

Purpose: To provide clinicians with a practical, user-friendly guide to the assessment of competence of patients with regard to consent to treatment.

Content: This book covers the concept of competence and its place in the doctrine of informed consent, the circumstances in which the issue of competence arises, the assessment of competence, and decision-making procedures for incompetent patients.

Highlights: The book is short and concise despite the complexity of the subject. Convenient chapter summaries and illustrative clinical vignettes are provided. An appendix contains the format, procedure, and data recording form of the MacArthur Competence Assessment Tool-Treatment, a semistructured interview instrument developed by the authors to systematically elicit and organize information about decision-making abilities.

Limitations: The only illustrations are six tables and the data collection form. Although the references are carefully chosen, pertinent, and clinically useful, there are only 37 of them.

Related reading: Other books available on this subject are much less clinically oriented, focusing instead on legal, ethical, and policy analyses. These include Competence to Consent, by White (Georgetown Univ Pr, 1994); Decision-Making and Problems of Competence, edited by Grubb (J Wiley, 1994); and Informed Consent: Patient Autonomy and Physician Beneficience within Clinical Medicine, by Wear (Kluwer, 1993).

Reviewer: Douglas E. Tucker, MD, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois.