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Competency - Who Should Evaluate Competency?

nursing physician clinical journal american consent treatment

Although competency is at root a legal determination, physicians routinely make competency judgments in the acute care setting. While these determinations could theoretically be challenged in court retrospectively, they rarely are. For non-urgent competency evaluations, such as competency of a person for nursing home placement, a court hearing must be held and a formal guardian appointed. Physicians' opinions are rarely challenged in these more formal legal settings. What type of physician should make competency evaluations? The answer is relative to the situation. Psychiatrists and clinical psychologists are the most trained to recognize and treat mental illness. Many of these specialists are experienced in competency evaluations. However, if a patient is comatose, severely demented, or wildly psychotic, and the situation is urgent, an expert opinion may be superfluous; the competency determination may be readily handled by the primary physician.



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