Competency of aMCI patients to consent to cholinesterase treatment

In medical practice, a patient's loss of competency is a major obstacle when choosing a treatment and a starting treatment program smoothly. A large number of studies have revealed the lack of medical competency in patients with dementia. However, there have been only a few reports focusing on...

Full description

Saved in:
Bibliographic Details
Published in:International psychogeriatrics 2020-02, Vol.32 (2), p.211-216
Main Authors: Oshima, Etsuko, Takenoshita, Shintaro, Iwai, Risa, Yabe, Mayumi, Imai, Nao, Horiuchi, Makiko, Takeda, Naoya, Uchitomi, Yosuke, Yamada, Norihito, Terada, Seishi
Format: Article
Language:English
Subjects:
Activities of daily living
Age
Aged
Aged, 80 and over
Atrophy
Cholinesterase Inhibitors - therapeutic use
Cognition & reasoning
Cognitive ability
Cognitive Dysfunction - drug therapy
Cognitive Dysfunction - psychology
Consciousness
Decision Making
Dementia
Dentistry
Diarrhea
Drug dosages
Fainting
Female
Humans
Informed Consent - standards
Japan
Male
Memory
Mental Competency - psychology
Middle Aged
Neuropsychological Tests
Patients
Pharmaceutical sciences
Psychologists
Treatment programs
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:In medical practice, a patient's loss of competency is a major obstacle when choosing a treatment and a starting treatment program smoothly. A large number of studies have revealed the lack of medical competency in patients with dementia. However, there have been only a few reports focusing on the capacity of patients with mild cognitive impairment (MCI) to make a medical choice. In this study, we evaluated the competency of 40 patients with amnestic MCI (aMCI) and 33 normal subjects to make a medical choice using the MacArthur Competence Assessment Tool-Treatment (MacCAT-T). We compared the judgement of a team conference using the recorded semi-structured interview with the clinical judgement of a chief clinician. A team conference concluded that 12 aMCI patients had no competency, and the clinical judgement, without any special interview, judged that five aMCI patients had no competency. All subjects in the control groups were judged to be competent to consent to treatment by both clinicians and the team conference. Without supplementary tools such as explanatory documents, not a few patients with aMCI were judged by a team conference to have no competency to consent to therapy even in a relatively simple and easy case. In contrast, clinical physicians tended to evaluate the competency of aMCI patients in a generous manner.
ISSN:1041-6102
1741-203X
DOI:10.1017/s1041610219000516