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Biomedical subjects

F Lowy

Publications and source records attributed to F Lowy.

9 recordsLinked to original sources
PubMed1996

Competency assessments: perceptions at follow-up.

OBJECTIVES: To report on the perceptions of assessment of competency and its consequences on a group of clients and significant others at follow-up. METHODS: Ninety-five interviews were conducted using a carefully developed semistructured telephone interview of 24 clients and 71 family/caregivers, representing the perceptions of about 80 clients. RESULTS: There was general satisfaction in the competency assessment process. There was a perception that interests and rights were protected. Clients were seen to be less involved in all spheres of decision making regardless of capacity outcome. Clients and families were satisfied with how decisions were made. CONCLUSIONS: Follow-up study of competency assessment does not support the conclusions previously drawn based on court record studies that assessments are deleterious and frequently result in violations of rights.

Adolescent↗
PubMed1995

Suicide: the interaction of clinical and ethical issues.

Although bioethical principles such as beneficence, nonmaleficence, and autonomy increasingly guide clinical decision making, in good clinical practice none of these principles is absolute. The authors describe how clinical and ethical issues interact in prioritizing principles in the treatment of suicidal patients. For the acutely suicidal patient, beneficence must be given primacy, as it should for the chronically suicidal patient who is unable to control self-destructive impulses. However, some chronically suicidal patients may be capable of resisting these impulses, and in such situations, respecting patients' autonomy facilitates clinical work and prevents the therapist from being drawn into a role that encourages regression. The successful management of the suicidal patient illustrates the need for dynamic, rather than rigid, application of ethical principles.

Beneficence↗
PubMedDate not supplied

Psychiatric consultation for competency to refuse medical treatment. A retrospective study of patient characteristics and outcome.

Forty-one psychiatric consultations on medical-surgical inpatients for competency to refuse medical treatment were studied retrospectively. The competent (n = 16) and incompetent (n = 25) patients were compared in terms of demographic data, diagnoses, clinical variables, details about treatment refusal, and outcome following competency assessment. The incompetent patients tended to be men, the focus of more urgent requests, and to have refused operations. The incompetent patients tended to have organic brain syndromes; the competent patients had personality disorders, adjustment disorders, or no psychiatric diagnosis. Ultimate acceptance of treatment initially refused was common in both groups; differential psychiatric interventions were recommended. The process of psychiatric consultation appeared to facilitate acceptance of treatment initially refused.

Adult↗