Decision-making capacity for treatment in psychiatric and medical in-patients: Cross-sectional, comparative study

Gareth S. Owen; George Szmukler; Genevra Richardson; Anthony S. David; Vanessa Raymont; Fabian Freyenhagen; Wayne Martin; Matthew Hotopf

doi:10.1192/bjp.bp.112.123976

Decision-making capacity for treatment in psychiatric and medical in-patients: Cross-sectional, comparative study

Gareth S. Owen^*, George Szmukler, Genevra Richardson, Anthony S. David, Vanessa Raymont, Fabian Freyenhagen, Wayne Martin, Matthew Hotopf

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Is the nature of decision-making capacity (DMC) for treatment significantly different in medical and psychiatric patients? Aims: To compare the abilities relevant to DMC for treatment in medical and psychiatric patients who are able to communicate a treatment choice. Method: A secondary analysis of two cross-sectional studies of consecutive admissions: 125 to a psychiatric hospital and 164 to a medical hospital. The MacArthur Competence Assessment Tool - Treatment and a clinical interview were used to assess decision-making abilities (understanding, appreciating and reasoning) and judgements of DMC. We limited analysis to patients able to express a choice about treatment and stratified the analysis by low and high understanding ability. Results: Most people scoring low on understanding were judged to lack DMC and there was no difference by hospital (P=0.14). In both hospitals there were patients who were able to understand yet lacked DMC (39% psychiatric v. 13% medical in-patients, P

Original language	English
Pages (from-to)	461-467
Number of pages	7
Journal	The British Journal of Psychiatry
Volume	203
Issue number	6
DOIs	https://doi.org/10.1192/bjp.bp.112.123976
Publication status	Published - Dec 2013

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AU - David, Anthony S.

AU - Raymont, Vanessa

AU - Freyenhagen, Fabian

AU - Martin, Wayne

AU - Hotopf, Matthew

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Decision-making capacity for treatment in psychiatric and medical in-patients: Cross-sectional, comparative study

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