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Related Experiment Videos

Informed consent--mandating the consultation.

J J Strain, Z Taintor, L H Gise

    General Hospital Psychiatry
    |July 1, 1985
    PubMed
    Summary
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    Mandatory psychiatric consultations in hospitals identify significant psychiatric issues in patients needing medical consent. This process ensures critical mental health conditions are diagnosed and treated, improving patient care.

    Area of Science:

    • Psychiatry
    • Hospital Administration
    • Medical Ethics

    Background:

    • Assessing patient capacity for medical consent is crucial.
    • Psychiatric conditions can impair decision-making abilities.
    • General hospitals may not routinely identify psychiatric comorbidities.

    Purpose of the Study:

    • To evaluate the effectiveness of a mandatory psychiatric consultation procedure.
    • To identify treatable psychiatric problems in patients referred for capacity assessment.
    • To determine the prevalence of major psychopathology in patients undergoing capacity evaluations.

    Main Methods:

    • A computerized data-based format was used to track psychiatric consultations.
    • 996 psychiatric consultations were reviewed.

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  • 372 patients (the "judgment" group) were referred for capacity to consent assessment, with 129 receiving psychiatric diagnoses and treatment recommendations.
  • Main Results:

    • 37.4% of psychiatric consultations were for capacity assessment.
    • 35% of patients in the "judgment" group received psychiatric diagnoses and treatment recommendations.
    • The "judgment" group showed significantly higher rates of organic brain syndrome and psychoses associated with CNS conditions compared to the "nonjudgment" group (p < 0.001).
    • The "nonjudgment" group had significantly higher rates of neurosis, alcoholism, and personality disorders (p < 0.001).

    Conclusions:

    • A mandatory psychiatric consultation procedure effectively identifies significant psychiatric problems.
    • Many patients with major psychopathology requiring treatment would be missed without mandated consultations.
    • The implementation of mandated psychiatric consultations in general hospitals is valuable for comprehensive patient care.