Informed consent and competency: doctor's dilemma on the consultation liaison service

With the increase in morbidity in the mentally ill, we also see an increase in the number of consultation requests from the medical and surgical departments to the psychiatric consultation team. Beside the classic questions of managing depression, psychosis, or agitation, psychiatrists are facing questions regarding patient competency. This usually refers to the patient's ability to consent to or refuse medical treatment, to be discharged against medical advice, or the patient's capacity to live independently and manage his or her own finances. In this article, the principles of informed consent and decision-making capacity will be reviewed, as well as the legal cases pertaining to these issues. A brief review of the existing literature will be summarized.