title: [Good medical care at the borderline of mental incompetence].
abstract: A 73-year-old woman with minor intellectual skills had complaints which suggested a vulvar carcinoma. Despite her refusal she was examined and admitted to hospital, on the basis of good professional care. The psychiatrist examined her and judged her incompetent. For the operation of the diagnosed vulvar carcinoma a court ordered representative was obtained. Two months later she underwent radiotherapy to prevent local complications and pain and a few weeks thereafter she died. Because medical decision-making in a doctor-patient relationship is not always possible decision-making power should be assigned to a third party. That forms the basis of proper medical care.
authors.affiliation: Afd.Gynaecologie, Leids Universitair Medisch Centrum, Leiden.
authors.forename: H T
authors.initials: HT
authors.lastname: Nagel
authors.forename: D P
authors.initials: DP
authors.lastname: Engberts
authors.forename: K
authors.initials: K
authors.lastname: van Leeuwen
authors.forename: G G
authors.initials: GG
authors.lastname: Kenter
mesh_terms: D000368:Aged; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000592:standards*; D004992:Ethics, Medical; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007872:Legal Guardians / Q000331:legislation & jurisprudence*; D007883:Legislation, Medical; D016743:Mental Competency; D009426:Netherlands; D019989:Persons with Intellectual Disabilities / Q000331:legislation & jurisprudence*; D010817:Physician-Patient Relations; D016312:Treatment Refusal; D014846:Vulvar Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*