Competence and decision-making: Ethics and clinical psychiatric practice

Abstract

The interface of psychiatry and the law is often unclear and complicated. Ethics in psychiatry is a complex, controversial, often ambiguous topic. Conflicts arise about confidentiality, informed consent, involuntary hosptialisation, right to treatment, right to refuse treatment amongst other daily clinical issues. There is an extended responsibility to others as well as to the mentally ill vulnerable persons. An overarching departure point would be to address “competence” so as to further understand the above issues. The making of decisions pertaining the health and personal issues is dependent on the ability of the patient to function in various areas. The concept of competency is differently viewed from clinical as compared to legal approaches. Some jurisdictions have introduced in legislature more specific legal guideline for recoding mental capacity.
This discussion takes a practical clinical approach and addresses a general approach to introduce an umbrella concept to relate to addressing individual ethical issues more specifically.