Competency and practical judgment.

At least four different frameworks--psychiatric, cognitive, functional and decision-making--are used in the evaluation of competence, all of which remain more or less unrelated in the literature. In the first section of this paper we consider various meanings of "competence," in order to arrive at a definition of the term relevant to the medical and legal setting. Patient or client "competence," we conclude, refers to the practical abilities that individuals employ in pursuing their own autonomous goals in life.