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Determination of Mental Competency, a Neurological Perspective

  • Behavior (HS Kirshner, Section Editor)
  • Published:
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Abstract

This article discusses the evaluation of the capacity of a person to make informed decisions about financial matters, independent living, and informed consent for medical treatment and research. Determination of capacity is a function for which most physicians have little training. The determination of competency for a general medical patient may be assessed by a combination of a bedside mental status examination such as the MMSE and a questionnaire such as the Aid To Capacity Evaluation (ACE 1999). For patients with focal neurological deficits such as aphasia, further evaluation of specific cognitive and language functions is needed; Alexander (Arch Neurol 45:23–6, 1988) suggested 7 specific functions to be assessed. Finally, in dementing illnesses, evaluation by the MMSE and a questionnaire such as the CCTI, or Capacity to Consent to Treatment Instrument (Marson et al. Arch Neurol 52:949–54, 1995) is needed. Dementia includes several separate syndromes of neurodegenerative disease, and in many of these conditions, focal deficits such as aphasia may necessitate a more thorough neuropsychological evaluation.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Conflict of Interest

Howard S. Kirshner declares that he has no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA

    Howard S. Kirshner

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  1. Howard S. Kirshner
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Correspondence to Howard S. Kirshner.

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This article is part of the Topical Collection on Behavior

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Kirshner, H.S. Determination of Mental Competency, a Neurological Perspective. Curr Neurol Neurosci Rep 13, 356 (2013). https://doi.org/10.1007/s11910-013-0356-1

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  • DOI: https://doi.org/10.1007/s11910-013-0356-1

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