Am J Psychiatry 1982; 139:910-913
Copyright © 1982 by American Psychiatric Association
The dilemma of denial in the assessment of competency to refuse treatment
LH Roth, PS Appelbaum, R Sallee, CF Reynolds and G Huber
To illustrate the dilemma in evaluating and treating patients who deny
their illness, the authors present the case of a woman with paranoia who
denied she was ill and refused medication. They focus specifically on the
issue of whether a patient who denies his or her illness is truly legally
competent to refuse or consent to treatment. They conclude that the
assessment of such competency requires a consideration of the accuracy of
the patient's "appreciation of the nature of his or her situation" and that
safeguards have to be built into a system for evaluating competency along
these lines to prevent abuse.
