Psychosomatics 1995; 36:33-41
Copyright © 1995 by Academy of Psychosomatic Medicine
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ORIGINAL RESEARCH REPORTS |
Psychiatric consultation for competency to refuse medical treatment. A retrospective study of patient characteristics and outcome
M Katz, S Abbey, A Rydall and F Lowy
Toronto Hospital, Department of Psychiatry, Ontario, Canada.
Forty-one psychiatric consultations on medical-surgical inpatients for
competency to refuse medical treatment were studied retrospectively. The
competent (n = 16) and incompetent (n = 25) patients were compared in terms
of demographic data, diagnoses, clinical variables, details about treatment
refusal, and outcome following competency assessment. The incompetent
patients tended to be men, the focus of more urgent requests, and to have
refused operations. The incompetent patients tended to have organic brain
syndromes; the competent patients had personality disorders, adjustment
disorders, or no psychiatric diagnosis. Ultimate acceptance of treatment
initially refused was common in both groups; differential psychiatric
interventions were recommended. The process of psychiatric consultation
appeared to facilitate acceptance of treatment initially refused.
