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Irwin Kleinman

Publications and source records attributed to Irwin Kleinman.

4 recordsLinked to original sources

Psychiatrists' documentation of informed consent: a representative survey.

OBJECTIVE: To review psychiatrists' documentation of informed consent and present data on Canadian psychiatrists' attitudes and practices regarding documentation of the informed consent process. METHOD: We surveyed a stratified random sample of psychiatrists practising in Ontario, using a mailed self-report questionnaire. RESULTS: The response rate was 72%. Among respondents, 63% routinely documented the consent process, with younger respondents reporting more documentation than older ones. Although most respondents (77%) favoured recording the consent process, only 11% felt signed consent forms were necessary. CONCLUSION: There are differences in the self-reported documentation behaviour of younger and older psychiatrists. Psychiatrists should document the consent process in the clinical record.

Adult↗

Informed consent and adolescents.

OBJECTIVE: To explore the doctrine of informed consent and the development of capacity in adolescents with psychiatric problems to help clinicians better reflect on the relevant ethical issues. METHOD: We discuss the relevant literature and explore the role of psychiatric impairment in adolescents' ability to consent. RESULTS: In common law, there is no minimum age at which individuals are able to consent to medical treatment and no age below which they are unable to consent. Adolescents' right to self-determination is based on their ability to understand and appreciate the information relevant to the medical decision and on their ability to consent voluntarily and freely. There is a consensus in the literature that, around age 14 years, adolescents have the cognitive ability to understand information necessary for consent. However, there are limited empirical data regarding adolescents' ability to appreciate the information and to make a voluntary decision. CONCLUSION: Clinicians need to involve adolescents in the consent process to the extent possible and assess the elements of capacity to consent to treatment on an individual case basis, recognizing that capacity may evolve as adolescents' cognitive capacities and values mature.

Adolescent↗

Psychiatrists' attitudes about and informed consent practices for antipsychotics and tardive dyskinesia.

This study provided representative data about the attitudes and behaviors of psychiatrists with respect to obtaining informed consent for antipsychotic medications. A cross-sectional representative survey of 617 psychiatrists, stratified by age and gender, was conducted by using a self-report questionnaire. The response rate was 72 percent (N=427). Demographic characteristics did not correlate with whether the respondents disclosed information about the potential side effect of tardive dyskinesia, which is associated with antipsychotic medications. Respondents' attitudes toward informed consent were a strong predictor of whether they disclosed information about antipsychotic medications and the risk of tardive dyskinesia. A total of 263 respondents (78 percent) routinely disclosed information about tardive dyskinesia.

Adult↗