Forensic Issues In Medical Evaluation: Competency And End-Of-Life Issues

Abstract

Decision-making capacity is a common reason for psychiatric consultation that is likely to become more common as the population ages. Capacity assessments are frequently compromised by misconceptions, such as the belief that incapacity is permanent or that patients with dementia categorically lack capacity. This chapter will review the conceptual framework of decision-making capacity and discuss its application to medical decision-making. We will review selected developments in capacity assessment and recommend an approach to assessing decision-making capacity. We will discuss the unique challenges posed by end-of-life care, including determining capacity, identifying surrogate decision-makers, and working with surrogate decision-makers. We will discuss clinical and legal approaches to incapacity, including advance directives, surrogate decision-makers, and guardians. We will discuss the legal standards based on which surrogates make medical decisions and outline options for resolving disagreements between clinical staff and surrogate decision-makers. We will offer recommendations for approaching decision-making capacity assessments.

Publication Date

1-1-2015

Publication Title

Advances in Psychosomatic Medicine

Volume

34

Number of Pages

36-48

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.1159/000369083

Socpus ID

84926302756 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/84926302756

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