Guardianship of people with mental disorders

The duty of a guardian is to protect a patient who is unable to care for himself or herself. Guardianship has been considered an abrogation of autonomy while conversely it often prevents irreversible harm to the patient. We examined the decision-making process for appointing a guardian in 60 cases from one mental health center in Israel, by examining the patients' medical records and court appeals. The results of our study suggest that guardians are usually appointed only in extreme cases, though alternative solutions are rarely sought, and that clear criteria for physicians when recommending guardianship are lacking.