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CHAPTER 65   Understanding Legal and Ethical Issues
TOPICS   Introduction ~ Informed Consent ~ Confidentiality ~ Capacity ~ Competency ~ Advance Directives ~ Surrogates
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Competency

Competency is a legal presumption applied to people when they become adults. Competency gives adults the right to negotiate certain legal tasks, such as make a will or enter into a contract. In most states, a person is considered competent at age 18, unless there is evidence to the contrary that persuades a court to declare the person incompetent. Once presumed to be competent, people are presumed to remain competent until they die, unless a court determines that a person is no longer competent based on evidence, often provided by a doctor.

A person who has lost abilities—for example, the ability to manage financial affairs or make health care decisions—may be declared incompetent by a court of law. The court looks at what the person needs to do and what he can actually do. When asked to make such a declaration, the court usually relies on information gathered from a medical evaluation of a person's specific abilities. Only a court can declare a person incompetent. Old age used to be but no longer is sufficient cause to declare a person incompetent. The court must consider a person's disabilities along with his remaining abilities and craft an order that addresses the person's individual needs.

When the court declares someone incompetent, it appoints a guardian, who assumes responsibility for some or all of the decisions for the incompetent person.

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