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Informed consent for neuroleptics with elderly patients in two settings
B S Gurian1, E H Baker, S Jacobson
1Harvard Medical School, Cambridge, Massachusetts.
Journal of the American Geriatrics Society
|January 1, 1990
Summary
Physicians often fail to obtain informed consent for neuroleptic medication in elderly patients, particularly in nursing homes. This practice disregards patient rights and may indicate poor quality of care.
Area of Science:
- Geriatric Medicine
- Psychiatry
- Bioethics
Background:
- Neuroleptic medications are frequently prescribed for elderly patients.
- Recent court rulings emphasize informed consent for
- exceptional
- medications.
Purpose of the Study:
- To evaluate physician compliance with informed consent requirements for neuroleptic prescriptions in aging populations.
- To assess prescribing practices in nursing homes versus psychiatric hospitals.
Main Methods:
- Four studies were conducted involving elderly patients in nursing homes and a psychiatric teaching hospital.
- Prescribing practices regarding informed consent for neuroleptics were analyzed.
Main Results:
- Nursing home physicians rarely informed patients of neuroleptic risks or sought consent, disregarding competency.
- In academic settings, consent and competency were presumed unless patients dissented.
- Significant gaps in informed consent practices were identified.
Conclusions:
- Prescribing practices for neuroleptics in elderly patients often conflict with legal and ethical standards.
- Failure to obtain informed consent represents a quality of care issue.
- Policy recommendations are needed to ensure patient rights and improve care.