PT  - JOURNAL ARTICLE
AU  - P L Schneider
AU  - K A Bramstedt
TI  - When psychiatry and bioethics disagree about patient decision making capacity (DMC)
AID  - 10.1136/jme.2005.013136
DP  - 2006 Feb 01
TA  - Journal of Medical Ethics
PG  - 90--93
VI  - 32
IP  - 2
4099  - http://jme.bmj.com/content/32/2/90.short
4100  - http://jme.bmj.com/content/32/2/90.full
SO  - J Med Ethics2006 Feb 01; 32
AB  - The terms “competency” and “decision making capacity” (DMC) are often used interchangeably in the medical setting. Although competency is a legal determination made by judges, “competency” assessments are frequently requested of psychiatrists who are called to consult on hospitalised patients who refuse medical treatment. In these situations, the bioethicist is called to consult frequently as well, sometimes as a second opinion or “tie breaker”. The psychiatric determination of competence, while a clinical phenomenon, is based primarily in legalism and can be quite different from the bioethics approach. This discrepancy highlights the difficulties that arise when a patient is found to be “competent” by psychiatry but lacking in DMC by bioethics. Using a case, this dilemma is explored and guidance for reconciling the opinions of two distinct clinical specialties is offered.