title: [Study of medical decisions in adult guardianship].
abstract: OBJECTIVE
  The present study investigated the current situation of medical decision-making for patients who cannot express their intentions, especially elderly patients.
  
  
  METHODS
  We sent a questionnaire to 63 medical institutions and 11 individual caseworkers in Miyagi prefecture. The questionnaire was designed to investigate: 1) the use of adult guardianship; 2) the process of obtaining medical consent; and 3) possible systems which would benefit patients.
  
  
  RESULTS
  Forty-four institutions (69.8%) and 11 (100%) caseworkers answered our questionnaires. Five institutions and 8 caseworkers had been required to make medical consent for their patients by clinicians. Four patients could not receive medical treatment because clinicians could not identify responsible persons for medical consent. Eighteen institutions and 8 caseworkers suggested an adult guardian would be a possible person to give medical consent if satisfying legal conditions.
  
  
  CONCLUSIONS
  The present study indicated the urgency of an appropriate system to obtain medical consent when patients cannot express their intentions.
authors.affiliation: Department of Traditional Asian Medicine, Graduate School of Medicine, Tohoku University.
authors.forename: Akira
authors.initials: A
authors.lastname: Takahashi
authors.forename: Koh
authors.initials: K
authors.lastname: Iwasaki
authors.forename: Nobuo
authors.initials: N
authors.lastname: Yaegashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D016330:Frail Elderly; D006801:Humans; D007872:Legal Guardians