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Presumptions respecting mental competence

K V Madigan1, D Checkland, M Silberfeld

  • 1Competency Clinic, Baycrest Centre for Geriatric Care, North York, Ontario.

Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
|April 1, 1994
PubMed
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The common law presumption of competence in clinical assessments is debated for individuals previously deemed incompetent. Reassessing decision-making capacity requires legislative clarity on whether to presume competence or incompetence.

Area of Science:

  • Clinical Psychology
  • Legal Medicine
  • Public Policy

Background:

  • Clinical assessment of decision-making capacity relies on presumptions of mental competence.
  • Reassessing individuals previously found incompetent raises specific challenges regarding these presumptions.

Purpose of the Study:

  • To examine the appropriateness of the common law presumption of competence in reassessment cases.
  • To explore arguments for and against retaining or adopting a presumption of incompetence in these specific scenarios.

Main Methods:

  • Analysis of legal and clinical arguments surrounding presumptions of competence.
  • Drawing on clinical experience from the Baycrest Competency Clinic.

Main Results:

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  • Arguments exist for both retaining a presumption of competence and adopting a presumption of incompetence in reassessment cases.
  • The issue is complex and involves balancing clinical judgment with legal principles.

    • Conclusions:

    • The question of presumptions in reassessment cases is ultimately a public policy issue.
    • Legislative resolution is required to provide clear guidance for clinical practice and legal proceedings.