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Overestimating patients' capacity

  • Peter Lepping (a1)
Summary

Clinicians regularly overestimate patients' capacity to make decisions. This may jeopardise their autonomous decision-making. It may lead to poor clinical outcomes for patients and has potential adverse legal consequences for clinicians. There is a need to use the legal principles of the Mental Capacity Act more rigorously.

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References
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1 Raymont, V, Bingley, W, Buchanan, A, David, AS, Hayward, P, Wessely, S, et al. Prevalence of mental incapacity in medical inpatients and associated risk factors: cross-sectional study. Lancet 2004; 364: 1421–7.
2 Kahn, DR, Bourgeois, JA, Klein, SC, Iosif, AM. A prospective observational study of decisional capacity determinations in an academic medical center. Int J Psychiatry Med 2009; 39: 405–15.
3 Owen, GS, Richardson, G, David, AS, Szmukler, G, Hayward, P, Hotopf, M. Mental capacity to make decisions on treatment in people admitted to psychiatric hospitals: cross sectional study. BMJ 2008; 337: a448.
4 Cairns, R, Maddock, C, Buchanan, A, David, AS, Hayward, P, Richardson, G, et al. Prevalence and predictors of mental incapacity in psychiatric in-patients. Br J Psychiatry 2005; 187: 379–85.
5 Okai, D, Owen, G, McGuire, H, Singh, S, Churchill, R, Hotopf, M. Mental capacity in psychiatric patients. Systematic review. Br J Psychiatry 2007; 191: 291–7.
6 Hotopf, M. Mental health law and mental capacity: dogma and evidence. J Ment Health 2006; 15: 16.
7 Lepping, P, Sambhi, RS, Williams-Jones, K. Deprivation of liberty safeguards – how prepared are we? J Med Ethics 2010; 36: 170–3.
8 Owen, GS, David, AS, Hayward, P, Richardson, G, Szmukler, G, Hotopf, M. Retrospective views of psychiatric in-patients regaining mental capacity. Br J Psychiatry 2009; 195: 403–7.
9 Beauchamp, T, Childress, J. Principles of Biomedical Ethics, 5th edn. Oxford University Press, 2001.
10 Lepping, P. Consent in psychiatry – an ethical review. Psychiatr Bull 2003; 27: 285–9.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Overestimating patients' capacity

  • Peter Lepping (a1)
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