Determining the decision-making capacity of a patient who refused food and water.
A terminal patient expressed the wish to hasten her death and refused nutrition. The psychiatrist asked to render an opinion relevant to her competence employed questions in a semi-structured interview derived from a new instrument originally designed to determine competence to create 'Advance Directives'. Although the patient ultimately demonstrated her resolve by totally ceasing fluid intake, the complexity of the case--including the question of the stability of her choice--illustrates the need for specific patient safeguards.
Terman
S A
SA
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D000368:Aged; D003657:Decision Making; D005066:Euthanasia, Passive / Q000523:psychology*; D005260:Female; D006801:Humans; D016743:Mental Competency; D010166:Palliative Care; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D019452:Terminally Ill / Q000523:psychology; D016312:Treatment Refusal / Q000523:psychology