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Published Online: 16 January 2023

Clinical Issues in the Assessment of Competency

Paul S. Appelbaum, M.D., and Loren H. Roth, M.D., M.P.H.Authors Info & Affiliations

Publication: FOCUS

Volume 21, Number 1

https://doi.org/10.1176/appi.focus.23022006

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Abstract

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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Information & Authors

Information

Published In

FOCUS

Volume 21 • Number 1 • Winter 2023

Pages: 106 - 110

History

Published in print: Winter 2023

Published online: 16 January 2023

Authors

Details

Paul S. Appelbaum, M.D.

From the Law and Psychiatry Program, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine. Address reprint requests to Dr. Appelbaum, Western Psychiatric Institute and Clinic, 3811 O' Hara St., Pittsburgh, PA 15261.

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Loren H. Roth, M.D., M.P.H.

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Funding Information

Supported in part by NIMH grant MH-27553 and the Foundations' Fund for Research in Psychiatry.

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Clinical Issues in the Assessment of Competency

Abstract

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