title: Determining the decision-making capacity of a patient who refused food and water.
abstract: 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.
authors.affiliation: Peaceful Transitions, 3636 Fourth Avenue, Suite 210, San Diego, CA 92103, USA. PeacefulTr@aol.com
authors.forename: S A
authors.initials: SA
authors.lastname: Terman
mesh_terms: 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