PSYCHOPHARMACOLOGICAL TREATMENT OF DELIRIUM TO RESTORE MENTAL-CAPACITY

The authors report four patient cases of delirium in which medications were used to restore mental capacity when life-or-death treatment dec isions were required. Although extensive literature on substituted jud gment exists for delirium and depression compromising capacity to make competent decisions, the authors could locate to articles proposing a ggressive delirium treatment for restoring patients' capacity to parti cipate in their own care. Without surgical intervention, all four of t he authors' patients faced imminent death. Without psychopharmacologic banishment of the patients' deliria, proxies would have been asked wh ether the patients should undergo potentially lifesaving but high-risk procedures. The patients would have lost the opportunity to express t heir wishes about heroic lifesaving medical measures.