A NONCOMPLIANT PATIENT WITH FLUCTUATING CAPACITY

Because of intermittent refusal of both dialysis and medications, seri al capacity assessments were made on a 38-year-old male on hemodialysi s and receiving TB treatment. His capacity to make an informed treatme nt decision appeared to fluctuate and despite multidisciplinary involv ement and a court determination that treatment should take place, ques tions remained as to how such a case should be managed in the patient' s best interest. The process of making a capacity determination was re viewed from both a psychiatric and legal viewpoint and alternative str ategies presented. (C) 1998 Elsevier Science Inc.