title: Capacities of hospitalized, medically ill patients to consent to treatment.
abstract: 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.
authors.affiliation: Department of Psychiatry, University of Massachusetts Medical Center, Worcester 01655, USA.
authors.forename: P S
authors.initials: PS
authors.lastname: Appelbaum
authors.forename: T
authors.initials: T
authors.lastname: Grisso
mesh_terms: D000328:Adult; D000368:Aged; D032882:Comprehension; D035061:Control Groups; D030881:Disclosure; D005260:Female; D006760:Hospitalization / Q000331:legislation & jurisprudence*; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence*; D008297:Male; D016743:Mental Competency / Q000331:legislation & jurisprudence*; D008609:Mental Status Schedule; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D009483:Neuropsychological Tests; D018570:Risk Assessment; D012307:Risk Factors