[Informed consent and patient competence in the psychically ill. A review of empirical studies]

In clinical practice, patients' self-determination has become more and more important. However, in psychiatry, the practice of informed consent encompasses several problems. In many cases the psychiatrist is faced with the issue of determining patients' competence. This paper gives an overview of empirical studies on competence assessment in psychiatry. In the course of some of these studies, test instruments were developed which allow objective and reliable assessment of different standards of competence. The applicability of these tests is discussed. We present empirical data on the relationship between competence and psychopathologic symptoms and cognitive factors. In recent empirical research, a shift from an initial skepticism of the applicability of informed consent in psychiatry towards a more differentiated approach and an interest in multidisciplinary research can be observed.