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Competence of voluntary psychiatric patients to give valid consent to neuroleptic medication

Published online by Cambridge University Press:  02 January 2018

Moli Paul*
Affiliation:
Parkview Clinic, 60 Queensbridge Road, Moseley, Birmingham B13 8QE
Femi Oyebode
Affiliation:
South Birmingham Mental Health NHS Trust, Vincent Drive, Birmingham B15 2TZ
*
Correspondence
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Abstract

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Aims and method

To ascertain the competence of voluntary psychiatric patients to consent to neuroleptic medication and whether there is a hierarchy of tests of competence. A prospective, observational study of consecutive, voluntary admissions to an acute ward using a questionnaire designed to test four levels of competence, the Mini-Mental State Examination and the Brief Symptom Inventory.

Results

All subjects (n=40) could communicate a choice; 5% were competent at all levels. Tests were arbitrary and not hierarchical. Symptom relief/trust in doctors motivated most decisions to accept treatment.

Clinical implications

The number and identity of individuals identified as competent will vary with the test set, and tests limited to cognitive criteria will not cover the complexity of the task.

Type
Original Papers
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 1999 The Royal College of Psychiatrists

Footnotes

This paper formed part of the dissertation that won the Howard White Memorial Prize in 1998.

References

Appelbaum, P. S. & Grisso, T. (1988) Assessing patients' capacities to consent to treatment. New England Journal of Medicine, 319, 1635 1638.CrossRefGoogle ScholarPubMed
Department of Health & Welsh Office (1993) Code of Practice Mental Health Act 1983. London: HMSO.Google Scholar
Derogatis, L. R. & Melisaratos, N. (1983) The Brief Symptom Inventory: an introductory report. Psychological Medicine, 13, 595 605.Google Scholar
Folstein, F., Folstein, S. E. & McHugh, P. R. (1975) ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189 198.Google Scholar
Grant, L. (1998) Remind Me Who I Am, Again. London: Granta Books.Google Scholar
Law Commission (1993a) Mentally Incapacitated Adults and Decision-Making . A New Jurisdiction, Consultation Paper No. 128. London: HMSO.Google Scholar
Law Commission (1993b) Mentally Incapacitated Adults and Decision-Making . Medical Treatment and Research, Consultation Paper No. 129. London: HMSO.Google Scholar
Law Commission (1995) Mental Incapacity, Report 231. London: HMSO.Google Scholar
Lord Chancellors Office (1997) Who Decides? Making Decisions on Behalf of Mentally Incapacitated Adults. London: The Stationery Office.Google Scholar
Roth, L. H., Appelbaum, P. S., Sallee, R., et al (1982) The dilemma of denial in the assessment of competency to refuse treatment. American Journal of Psychiatry, 139, 910 913.Google Scholar
Silverman, W. A. (1989) The myth of informed consent: in daily practice and in clinical trials. Journal of Medical Ethics, 15, 6 11.Google Scholar
Smith, R. (1998) Informed consent: edging forwards (and backwards). British Medical Journal 316, 949 951.Google Scholar
Tancredi, L. (1982) Competency for informed consent. Conceptual limits of empirical data. International Journal of Law and Psychiatry, 5, 51 63.Google Scholar
L. v. Bournewood Communith and Mental Health Trust ex parte L. (1998) I, All ER, 634.Google Scholar
Sidaway v. Bethlem Royal Hospital Governors And Others (1985) 1, All ER.Google Scholar
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