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Results for “Legal Guardians”

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At least 19 recordsLinked to original sources
PubMed2002

Guardianship primavera: a first look at factors associated with having a legal guardian using a nationally representative sample of community-dwelling adults.

Although guardianship is an intrusive intervention that usually removes an adult's basic civil rights, studies of factors that place adults at risk for guardianship have largely been based on small studies of court files. While important and informative, these studies do not allow us to draw anything but tentative conclusions on risk factors for guardianship. The purpose of this article is to examine risk factors for having a legal guardian using a nationally representative sample for the first time. Logistic regression was conducted on the probability of having a legal guardian, using the Andersen model of health care utilization adapted for factors implied by the guardianship literature. The National Health Interview Supplement on Disability (1995) sample consisted of 65,013 adults aged 19 and older, and a sub-sample aged 60 and older (n = 13,784). Results indicate, first, that the prevalence of guardianship in community-dwelling adults is 0.3 percent, or over 750,000 people. Second, particularly for older adults, increasing age, having physical or emotional limitations, a small family network, and not living with a spouse are associated with having a guardian. Decreasing size of family networks and increasing marital disruption in future cohorts of older adults may suggest increasing need for legal guardianship. Further study should be conducted to replicate these findings in other large data sets and in extensive community studies.

Adult↗
PubMed1988

The psychiatrist as legal guardian.

Most discussions about legal guardianship pertain to special populations, such as the mentally retarded or demented. Except for the case of refusal of antipsychotic medication, little has been written about using guardianship to authorize nonemergency treatment for a person who is mentally ill and treatable. The authors present several cases in which a consulting or administrative psychiatrist served as a temporary guardian for a hospitalized patient's personal affairs. The psychiatrist-guardian authorized diagnostic procedures or ECT for the temporarily incompetent patient and was then discharged as guardian. The authors discuss the problems and limitations of such a role for the psychiatrist.

Aged↗
PubMed1991

Elderly wards and their legal guardians: analysis of county probate records in Ohio and Washington.

We examined the demographic profiles of older wards and their guardians in Ohio and Washington states. The adjudication process, as experienced by older persons placed in legal guardianship, was also explored. Findings suggest that current state statutes of guardianship as they pertain to elders may not be feasible or fair. In particular, standardized and reliable assessments of competency are lacking; a family member's petition for guardianship is seldom challenged by the older person; and the primary goal of most guardianship cases to preserve the estate of the older individual.

Aged↗
PubMed1989

[Determination of incompetency and the functions of the legal guardian in decision processes regarding medial treatment for the ward].

In this article the author gives a general overview of the classification of incompetent persons, the determination of competency, and the role of the guardian or tutor according to the Civil Code of the Commonwealth of Puerto Rico. The article takes into consideration the special characteristics of the hospitals and the medical profession. Finally, the author gives his recommendations as to how hospitals and physicians should act in situations that involve incompetent patients in order to minimize the risk of possible legal responsibility.

Persons with Disabilities↗
PubMed1983

Medical genetics, Huntington's chorea, and legal questions pertaining to autopsy.

A family with Huntington's chorea was evaluated. The 65-year-old male proband had been diagnosed as a paranoid schizophrenic. Because of Huntington's chorea in the family, he was considered "affected" by many of his relatives. Following his death, autopsy was refused by the patient's son, who had been his legal guardian. Legal consultation eventually led to autopsy, which showed no evidence of Huntington's chorea. Genetic counselling was provided for his children and siblings. Pertinent legal and neuropsychiatric issues in Huntington's disease are reviewed.

Aged↗
PubMed1996

Reducing missed opportunities for immunizations. Easier said than done.

BACKGROUND: Missed opportunities for immunizations are associated with underimmunization of preschool-age children. Practice policies limiting immunizations to scheduled preventive visits and guidelines requiring legal guardians to sign consent forms for vaccinations are 2 factors contributing to missed opportunities. However, methods to change these policies have not been sufficiently evaluated. OBJECTIVE: To measure the effectiveness of (1) changing practice policies to incorporate the new national standard to screen and vaccinate eligible children at all office visits and (2) eliminating legal guardian signature requirements. DESIGN: A randomized controlled trial of 2 interventions: (1) changing practice policy and routine to have office nurses screen for immunization status at all visits, attach immunization reminder cards to medical charts for eligible patients, and have providers vaccinate eligible children ("no missed opportunities" intervention) and (2) changing practice guidelines to allow vaccinations without a legal guardian's signature. The first intervention was performed at both sites; the second only at the neighborhood health center (NHC). SETTING: A Pediatric Continuity Clinic in a teaching hospital (hereafter referred to as Clinic), and an NHC. PATIENTS: Enrolled in the trial were 1005 Clinic patients and 983 NHC patients, 0 to 2 years of age. MAIN OUTCOME MEASURES: Missed opportunity rates, immunization rates, and rates of preventive services. RESULTS: Eliminating the requirement for a legal guardian's signature had no effect on any of the outcome measures. The no missed opportunities intervention was partially effective. Study patients had slightly fewer missed opportunities than control patients at each site: (0.60 vs 0.90 per patient per year at the Clinic, P = .01; 1.1 vs 1.3 per patient per year at the NHC, P = .02). For study group patients, immunization reminder cards were attached to medical charts in only one third of vaccine-eligible visits; when attached, they markedly increased vaccination by providers (odds ratio for vaccinating at a visit was 6.9 comparing visits when immunization reminder cards were attached vs not attached). However, at the end of the study, immunization rates were similar for study and control groups at each site. The number of undervaccinated days was slightly lower for the no missed opportunities study group at the Clinic than for the control group (56 days vs 77 days, P < .001), but they were similar for both groups at the NHC. There were no differences in rates of preventive visits or screening tests between study and control groups. CONCLUSIONS: The interventions evaluated to reduce missed opportunities did not increase immunization rates. The key problem was failure to screen for immunization status at all visits. More effective interventions will be needed to overcome barriers within busy primary care practices to substantially reduce missed opportunities.

Female↗
PubMed2004

[Psychiatric examination performed by phone to determine guardianship--is it legally valid?].

BACKGROUND: The administration of a psychiatric evaluation to determine guardianship entails the prerequisite of a full psychiatric examination of the patient. In psychogeriatrics, dementia is the common reason for measures to determine incompetence and guardianship and in general psychiatry it is applicable for the diagnosis of schizophrenia. Legal guardianship is determined by the court and can apply to aspects involving confidentiality such as the patient's assets or body or both, and its duration can be temporary or permanent. This is a case study of a 30 year old man who had never undergone a psychiatric examination. His parents reported behavior that was suggestive of a prolonged paranoid psychotic state for the past 8 years with deterioration in the last year. All attempts by his parents to bring him to a medical or psychiatric examination were refused by the patient. In order to prevent further deterioration of the situation, the family was advised to request legal guardianship for him. Due to his refusal to be examined and the lack of indication for a forced examination, a long taped phone conversation was conducted with the patient and later validated to ensure that this was the patient in question. This conversation together with heteroanamnesis, provided the basis for writing a psychiatric evaluation recommending the appointment of a legal guardian for the patient. To the best of our knowledge, the court's decision to appoint a legal guardian based on a telephone conversation is a precedent.

Confidentiality↗
PubMed2003

Legal and assistance aspects of Alzheimer's disease: analysis of 100 cases.

Caring for patients with disabling cognitive diseases, such as Alzheimer's disease (AD) and other progressive dementias, has a number of legal and social welfare implications. The two main problems to be discussed with patients and caregivers are the need for a legal guardian and requests for government financial support, both of which depend on the patient's progressive loss of autonomy and increasing need for assistance. In order to study the presence of these two support measures, we considered 100 AD patients (56 women and 44 men) divided in four groups on the basis of the stage of the disease: mild (25), moderate (34) and severe (32), or death (9). We investigated the number of caregivers for each patient (and their relationship with the patient), the presence of a legal guardian, and whether government financial support had been obtained. The number of caregivers increased for each patient as the disease advanced (54% with moderate and 67% with severe disease had > or =1 caregiver), but only 11% of the patients had a guardian. The caregivers were most likely to be family members (70% were spouses, 45% offspring). Only 23% of the patients with moderate and 62% with severe disease received government financial support. Our data concerning the care of incompetent people (as AD patients progressively become) in juridical (guardianship/trusteeship/proxy/power of attorney) and social terms (government financial support) show that such aspects are not sufficiently taken into account until the patients reach a severe disease or have died.

Aged↗
PubMed2006

Informed consent for therapy and research in continuous renal replacement therapy: an international survey.

OBJECTIVE: To study the approach of health care workers (HCW) to informed consent for therapy and research in the field of continuous renal replacement therapy (CRRT). DESIGN: Administration of questionnaire. SETTING: Two International Courses on Critical Care Nephrology (CCN) held in Vicenza and Melbourne. PARTICIPANTS: Eight hundred and twenty one course participants. RESULTS: We obtained 349 analysable questionnaires (42.5% of participants). Only 22.5% of responders always obtain informed consent for CRRT; 70.3% just inform patients/relatives without seeking consent, 7.1% never obtain informed consent. In ICU patients, informed consent is considered 'good, correct and feasible' for therapy and for research by only 13% and 27% of responders, respectively. Consent for clinical research obtained from the next of kin or legal guardian is considered good, correct and feasible' by 56.3% of respondents, while 39.1% believe that next of kin or legal guardians can not really make informed decisions. Finally, nearly half of responders think that present rules hamper research in ICU. For many questions, significant variability of responses was found according to profession, specialty and origin of responders. CONCLUSIONS: In the field of CRRT, stated practice, beliefs and currently accepted ethical standards vary greatly according to profession, specialty and origin. A significant disagreement between what is widely promoted to be the 'correct' approach and what is currently done is evident.

Attitude of Health Personnel↗
PubMed1987

Act, 29 April 1987.

This Act amends Sections 36-2152 36-2153 of the Arizona Revised Statutes, which deal with parental notification requirements for abortions performed on minors. It replaces such notification requirements with a requirement that the treating physician receive written consent from one of the minor's parents or the minor's legal guardian before an abortion is performed. It also eliminates an exception to the notification requirement in cases where the parent or legal guardian cannot be located.

Abortion, Induced↗
PubMed2000

Legal responsibilities when fitting minors with contact lenses.

BACKGROUND: Practitioners must understand their legal responsibilities in fitting minors with contact lenses, which include informed consent, contractual obligations, and the Statute of Limitations. Minors are children and teenagers who have not yet reached voting age in their state--generally 18 years of age. Informed consent requires permission from the patient before a practitioner performs any treatment. For these young people, this consent generally can only be given by a parent or legal guardian. Minors can repudiate contracts made with them; therefore, the contractual obligation to pay for a contact lens fitting should be established with a parent or legal guardian. In most states, minors have additional time beyond the usual Statute of Limitations to bring a lawsuit. If practitioners recognize their legal responsibilities in caring for these special patients, fitting youngsters with contact lenses can be a rewarding part of practice.

Adolescent↗
PubMed1986

[Legal principles of organ transplantations].

In 1982 organ donation from deceased persons was put on a statutory footing, thus eliminating to a large extent any relevant legal uncertainty that had existed formerly. Organ donation from corpses is now legal - provided the patient or his legal guardian does not object to such donation before the former's death. Special permission is not required. Any objection voiced by a family member who is not acting as a legal guardian may be dismissed altogether. Before organ donation, proof of the onset of death has to be furnished by a physician authorized to exercise his profession. Detailed provisions under the law stipulate a ban on any profit-making action, the guarding of professional secrecy, as well as the appropriate keeping of records. Contrary to organ donation from deceased persons, organ donation from persons yet alive is still considered bodily injury under the penal code; such action can only be within the law if the donor him- or herself gives express permission in advance.

Austria↗