Clinicians' guidelines for assessing and presenting subtle forms of patient incompetence in legal settings

• Published in: The American journal of psychiatry Vol. 143; no. 8; p. 1020
• Main Authors: Gutheil, T G, Bursztajn, H
• Format: Journal Article
• Language: English
• Published: United States 01-08-1986
• Subjects: Adolescent; Adult; Anorexia Nervosa - diagnosis; Anorexia Nervosa - psychology; Bipolar Disorder - diagnosis; Bipolar Disorder - psychology; Depressive Disorder - diagnosis; Depressive Disorder - psychology; Documentation; Female; Forensic Psychiatry; Humans; Male; Mental Disorders - diagnosis; Mental Disorders - psychology; Mentally Ill Persons; Middle Aged; Patient Advocacy; Patient Compliance; Schizophrenia, Paranoid - diagnosis; Schizophrenia, Paranoid - psychology; United States; United States; Legal Approach; Professional Patient Relationship; Mental Health Therapies
• ISSN: 0002-953X
• DOI: 10.1176/ajp.143.8.1020

Even for nonforensic clinicians, the assessment of the patient's competence has grown in importance, particularly regarding the issues of informed consent and right to treatment. However, the incompetence of patients with paranoid states, depression, mania, and anorexia nervosa may be so subtle that both assessors and the court are deceived, incompetence is not recognized, and treatment is stalemated. The authors provide guidelines designed to equip the clinician to assess--and to present in an effective manner in court--the clinical findings relevant to incompetence, to the benefit of both the patient's rights and treatment.