title: Capacity of forensic patients to consent to treatment.
abstract: OBJECTIVE
  Lack of capacity to consent to psychiatric treatment has been promoted as a better basis for compulsion than mental disorder plus risk of harm. Previous research has examined how that legal change would affect acutely unwell inpatients. There is little research on forensic patients. This research aimed to assess capacity to consent in forensic patients at different stages of recovery and to consider the implications of respecting their competent treatment decisions.
  
  
  METHODS
  Capacity to consent was assessed in a cross-sectional sample of 109 forensic patients both in hospital and in community settings.
  
  
  RESULTS
  The majority of participants (67.6%) had treatment-related decision-making capacity. Very few patients with capacity refused treatment.
  
  
  CONCLUSIONS
  Change to a capacity-based legal approach may alter treatment for some forensic patients but would not necessarily increase risk of harm to others. The implications for release decisions are less clear.
authors.affiliation: Auckland Regional Forensic Psychiatry Services, Waitemata District Health Board, Auckland, New Zealand. Jeremy.skipworth@waitematadhb.govt.nz
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Skipworth
authors.forename: John
authors.initials: J
authors.lastname: Dawson
authors.forename: Pete M
authors.initials: PM
authors.lastname: Ellis
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence* / Q000523:psychology; D007297:Inpatients; D008297:Male; D016743:Mental Competency / Q000331:legislation & jurisprudence* / Q000523:psychology; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*