title: The dilemma of denial in the assessment of competency to refuse treatment.
abstract: To illustrate the dilemma in evaluating and treating patients who deny their illness, the authors present the case of a woman with paranoia who denied she was ill and refused medication. They focus specifically on the issue of whether a patient who denies his or her illness is truly legally competent to refuse or consent to treatment. They conclude that the assessment of such competency requires a consideration of the accuracy of the patient's "appreciation of the nature of his or her situation" and that safeguards have to be built into a system for evaluating competency along these lines to prevent abuse.
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003717:Denial, Psychological; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence*; D001523:Mental Disorders / Q000628:therapy*; D028642:Persons with Psychiatric Disorders; D010259:Paranoid Disorders / Q000523:psychology / Q000628:therapy; D010349:Patient Compliance; D026684:Personal Autonomy; D014481:United States
chemical_list: D014150:Antipsychotic Agents