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Published on: May 19, 2015
Depression and competence to refuse psychiatric treatment
1Department of Behavioral Sciences, Tel Aviv University School of Medicine, Israel. harudnick@hotmail.com
Journal of Medical Ethics
|June 4, 2002
Summary
Major depression can impair a person's ability to make consistent treatment choices. Competence to refuse psychiatric treatment requires evaluating preferences over time, not just current decision-making capacity.
Area of Science:
- Psychiatry
- Clinical Psychology
- Bioethics
Background:
- Individuals with major depression often refuse necessary psychiatric treatment.
- Assessing competence to refuse treatment is crucial for patient autonomy and well-being.
Observation:
- Standard competence criteria (choice, understanding, appreciation, reasoning) may not adequately capture the impact of depression.
- Major depression can alter personal preferences, affecting the coherence of treatment decisions.
Findings:
- Competence to refuse psychiatric treatment may be compromised if depression disrupts the consistency of personal preferences.
- Comparing current preferences with those from non-depressed periods is essential for evaluating competence.
Implications:
- Treatment refusal in depressed individuals may need re-evaluation if preferences are inconsistent.
- Overriding refusal may be necessary to treat depression and enable a competent decision.
- Further research is needed on depression's impact on psychiatric treatment competence.
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