Q. I am an RN on a geriatric psychiatry and want to know the latest and up-to-date information on psychiatric consents. We seem to have a lack of information on this subject at our facility thanks. Can you help?

A. Medical consent is a complicated issue in all circumstances, and likely more so in psychiatry in that it requires the patient to be competent to make important decisions. Consent involves medical and legal issues, so a good start would be to contact your state and local medical organizations and see what guidelines they can provide. Consent is an active and evolving topic, and a lot of thoughtful articles are published every year.

Here are some recent published references which should be available through your local hospital or medical school library:

1. Pinals DA, Appelbaum PS.
The history and current status of competence and informed consent in psychiatric research. Isr J Psychiatry Relat Sci. 2000;37(2):82-94.

2. Berghmans RL.
Informed consent for psychiatric research: the case of medication-free research. Med Law. 1999;18(4):515-24. Review.

3. Wystanski M.
Informed consent and psychiatric patients. Am J Psychiatry. 1999 Nov;156(11):1841-3.

4. Miller FG, Pickar D, Rosenstein DL.
Addressing ethical issues in the psychiatric research literature. Arch Gen Psychiatry. 1999 Aug;56(8):763-4.

5. Melamed Y, Kimchi R, Shnit D, Moldavski D, Elizur A.
Clinical assessment of competency to consent to psychiatric hospitalization. Int J Law Psychiatry. 1999 Jan-Feb;22(1):55-64.

6. Wettstein RM.
The right to refuse psychiatric treatment. Psychiatr Clin North Am. 1999 Mar;22(1):173-82, viii. Review.

7. Guidelines for assessing the decision-making capacities of potential research subjects with cognitive impairment. American Psychiatric Association. Am J Psychiatry. 1998 Nov;155(11):1649-50.

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