Blindness among nursing home residents
Letter to the Editor
New England Journal of Medicine
To the Editor: Tielsch et al. (May 4 issue)1 are to be commended for their thorough and clinically relevant research on visual impairment in nursing home residents. But why did the authors employ a cognitive examination as a screening instrument to determine whether they would approach subjects or proxies to obtain informed consent? This practice reflects the mistaken notion that the cognitively impaired cannot grant informed consent. Decision-making capacity is at issue in informed consent, not competency.2,3 The assessment of decision-making capacity occurs during the first two parts of an informed-consent interview: disclosure and understanding. A categorical assessment of. © 1995, Massachusetts Medical Society. All rights reserved.
Karlawish, J., Schainholz, D., Tielsch, J., Katz, J., Sommer, A., Klein, B., & Klein, R. (1995). Blindness among nursing home residents. New England Journal of Medicine, 333 (13). http://dx.doi.org/10.1056/NEJM199509283331315