Am J Psychiatry 1981; 138:1462-1467
Copyright © 1981 by American Psychiatric Association
Clinical issues in the assessment of competency
PS Appelbaum and LH Roth
The evaluation of a patient's competency to consent to treatment,
regardless of the test of competency used, can be substantially affected by
a number of clinical factors. The authors point out that, in assessing
competency, the clinician must consider 1) psychodynamic elements of the
patient's personality, 2) the accuracy of the historical information
conveyed by the patient, 3) the accuracy and completeness of the
information disclosed to the patient, 4) the stability of the patient's
mental status over time, and 5) the effect of the setting in which consent
is obtained. Inattention to these factors can lead to errors in assessment
of competency that can have important implications for patient care.
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