Mahler J, Perry S
New York Hospital-Cornell Medical Center, New York 10021.
Hosp Community Psychiatry. 1988 Aug;39(8):856-61. doi: 10.1176/ps.39.8.856.
Psychiatric consultants are increasingly asked to evaluate the competency of medically ill patients, but the absence of accepted guidelines and gaps in the law can make their task difficult. A model procedure for evaluating competency developed by the authors stresses the importance of conducting a complete clinical evaluation of the patient, prescribes interventions to clarify the role of the consultant for referring physicians, outlines medical and legal principles governing competency, and identifies the requirements of the consultant's note. Consulting psychiatrists cannot declare a patient legally incompetent; they can only give an opinion about the patient's apparent competency. They can withhold their opinion, however, until they have treated a psychiatric condition that may be affecting the patient's competency. Case vignettes illustrate the application of the guidelines.
精神科会诊医生越来越多地被要求评估患有内科疾病患者的行为能力，但缺乏公认的指导方针以及法律上的空白会使他们的任务变得困难。作者制定的一种评估行为能力的标准程序强调了对患者进行全面临床评估的重要性，规定了一些干预措施以向转诊医生阐明会诊医生的角色，概述了有关行为能力的医学和法律原则，并确定了会诊医生记录的要求。会诊精神科医生不能宣布患者无法律行为能力；他们只能就患者表面上的行为能力发表意见。不过，在治疗了可能影响患者行为能力的精神疾病之前，他们可以保留意见。案例 vignettes 说明了这些指导方针的应用。 （注：vignettes 这个词在医学文献中常指简短的病例描述，这里直接保留英文未翻译，因为不太清楚具体在文档中的准确含义，如果有准确含义要求，可进一步补充信息准确翻译）
