Abstract
Three instruments assessing abilities related to legal standards for competence to consent to treatment were administered to 6 groups: patients recently hospitalized for schizophrenia, major depression, and ischemic heart disease, as well as three groups of non-ill persons in the community who were matched with the hospitalized patients on age, gender, race, and socioeconomic status. Significant impairments in decisional abilities were found for only a minority of persons in all groups. Both the schizophrenia and depression groups manifested poorer understanding of treatment disclosures, poorer reasoning in decision making regarding treatment, and a greater likelihood of failing to appreciate their illness or the potential benefits of treatment. Deficits were more pronounced, however, among patients with schizophrenia. Implications are discussed for policy designed to protect the rights and welfare of patients with mental illness who are at risk of incompetent refusal or consent when making treatment decisions.
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This research was supported by the John D. and Catherine T. MacArthur Foundation Research Network on Mental Health and the Law. Other members of the Network are acknowledged for their conceptual guidance during the process of the study: Shirley Abrahamson, Richard Bonnie, Pamela Hyde, John Monahan, Stephen Morse, Ed Mulvey, Loren Roth, Paul Slovic, Henry Steadman, and David Wexler, as well as Steven K. Hoge. Acknowledged for their roles in data collection and statistical analysis are Kenneth Fletcher, Deidre Klassen and Cynthia Wickless. Requests for manuals for the MacArthur Treatment Competence Research Instruments.
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Grisso, T., Appelbaum, P.S. The MacArthur Treatment Competence Study. III. Law Hum Behav 19, 149–174 (1995). https://doi.org/10.1007/BF01499323
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DOI: https://doi.org/10.1007/BF01499323