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Medical Decisions in Question: Mental incapacity missed by docs

It's bad enough to be a patient in a hospital. What's worse, according to a team of British researchers, is that a substantial minority of medical patients is legally incompetent to make decisions about their treatment, yet their physicians often overlook this limitation.

Over an 18-month period, about one-third of a predominantly elderly group of people treated at a London hospital for at least 2 days exhibited an inability to understand the treatment decisions that they faced, say psychiatrist Matthew Hotopf of the Institute of Psychiatry in London and his colleagues. Yet physicians taking care of these patients rated only a small number of them as mentally incapacitated.

"More should be done to protect the interests of . . . the high proportion of medical patients who are treated without being able to give valid consent," the investigators conclude.

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