title: [The law of informed consent and its impasses in psychiatry].
abstract: Every medical intervention is submitted to the rule of informed consent. Over the years, criteria of consent validity and exception situations have been defined. After a discussion of the difficult application of the informed consent rule in psychiatry, this article suggests an analysis of the motivations of a refusal of neuroleptic medication in 20 psychotic patients of a psychiatric hospital. The irrational motivations of refusal (particularly, denial and delusional ideation) have been evoked much more often then rational motivations (therapeutic inefficiency, secondary effects). The authors question the denial as a sufficient reason to declare a psychotic patient incompetent to consent. The consequences of the refusal of the neuroleptic treatment in some patients, mainly the risk of criminalization, are discussed.
authors.forename: Y
authors.initials: Y
authors.lastname: Garneau
authors.forename: J M
authors.initials: JM
authors.lastname: Diener
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence*; D007872:Legal Guardians; D010344:Patient Advocacy / Q000331:legislation & jurisprudence; D010349:Patient Compliance; D011618:Psychotic Disorders / Q000188:drug therapy*; D011792:Quebec
chemical_list: D014150:Antipsychotic Agents
vernacular_title: La règle du consentement éclairé et ses impasses en psychiatrie.