Capacity of forensic patients to consent to treatment
Abstract
OBJECTIVE: Lack of capacity to consent to psychiatric treatment has been promoted as a better basis for compulsion than mental disorder plus risk of harm. Previous research has examined how that legal change would affect acutely unwell inpatients. There is little research on forensic patients. This research aimed to assess capacity to consent in forensic patients at different stages of recovery and to consider the implications of respecting their competent treatment decisions. METHOD: Capacity to consent was assessed in a cross-sectional sample of 109 forensic patients both in hospital and in community settings. RESULTS: The majority of participants (67.6%) had treatment-related decision-making capacity. Very few patients with capacity refused treatment. CONCLUSIONS: Change to a capacity-based legal approach may alter treatment for some forensic patients but would not necessarily increase risk of harm to others. The implications for release decisions are less clear.
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Unemployment was associated with incapacity in three studies.
“Unemployment was associated with incapacity in three studies (Curley, Murphy, Plunkett, et al., 2019c;Di & Cheng, 2013;Skipworth et al., 2013).”
From Decision making capacity for treatment in psychiatric inpatients: a systematic review and meta-analysis (2024) · cites this paper as Skipworth et al., 2013
Hallucinations were correlated with capacity in non-psychotic disorders, but not in psychotic disorders.
“Hallucinations were correlated with capacity in non-psychotic disorders (G.Owen et al., 2009), but not in psychotic disorders (Skipworth et al., 2013;Spencer et al., 2018).”
From Decision making capacity for treatment in psychiatric inpatients: a systematic review and meta-analysis (2024) · cites this paper as Skipworth et al., 2013
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Systematic review on the prevalence of lack of capacity in medical and psychiatric settings
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- Authors
- Skipworth, J. J., Dawson, J., & Ellis, P. M.
- Affiliations
- Waitemata District Health Board (NZ)
- University of Otago (NZ)
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
- Venue
- Australian & New Zealand Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2012-11-21
- Volume
- 47
- Issue
- 5
- Pages
- 443-450
- ISSN
- 0004-8674 (ISSN-L)
- 1440-1614
- OpenAlex
- W2331435405
- Cited by
- 15
- References
- 18
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2020: 1 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 3 · 2014: 1 · 2013: 2
- FWCI
- 2.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Australian & New Zealand Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- forensic patients, capacity to consent, psychiatric treatment, involuntary treatment, decision-making capacity, treatment refusal, release decisions, recovery
- MeSH terms
- Adult, Mental Disorders, Cross-Sectional Studies, Decision Making, Female, Humans, Informed Consent, Inpatients, Male, Mental Competency
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