ASSESSING COMPETENCE TO MAKE TREATMENT DECISIONS

The legal doctrine of informed consent dictates that all patients must be informed of the procedures, risks and benefits of any recommended treatment and available alternatives, and that patients' decisions mus t be informed, voluntary and competent. Assessing whether or not one's patient is competent to make treatment decisions, however, is a compl ex task even for highly trained clinicians. Although all patients are presumed to be competent unless demonstrated otherwise, the rate of in competence is increased in a number of patient populations such as the elderly, psychotic patients, the mentally retarded and individuals wi th severe medical disorders (e.g., cancer, AIDS). This paper offers gu idelines for assessing the decision-making capacity among medical and psychiatric patients, as well as discussing disposition issues when de cision-making abilities are indeed impaired. (C) 1998 Prous Science. A ll rights reserved.