Capacities of hospitalized, medically ill patients to consent to treatment

This study was designed to compare the abilities of hospitalized, medically ill patients with non-ill comparison subjects to engage in an informed consent process. Eighty-two inpatients under the age of 70 were recruited from patients admitted for evaluation or treatment of ischemic heart disease (N = 675). The comparison subjects (n = 82) were matched person-to-person on age, gender, race, educational level, and occupation and did not have histories of ischemic heart disease. The hospitalized subjects did not differ from the non-ill comparison subjects on three instruments developed to assess abilities related to decision-making competence. Demographic and mental state variables did not correlate with performance, except for verbal cognitive functioning. There is no reason to believe that hospitalized patients similar to this sample--even if being treated for potentially life-threatening conditions--are at increased risk of inability to engage in a meaningful informed consent process.