Abstract
By itself, the concept of competency is one that we rarely think about. It is only when doubt arises about someone’s mental ability to make rational decisions regarding his person or property that decisions about competency become important to us. The law presumes that adults are competent to manage their personal lives and their finances. In contrast, those under 18 years of age are deemed “minors” and for most purposes are considered legally incompetent. Competency forms the basis for being able to exercise our legal rights. These cover a wide range of areas, from personal decision making, such as marriage and refusal of treatment, to commercial transactions, such as purchasing a home. Legal competence serves as the foundation for participating in a variety of activities sanctioned by law, ranging from voting for elected officials to holding a professional license. One form of legal competence is required to participate in the trial process as a defendant and another to participate as a witness in court.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Bibliography
I. Competency A. Cases
Application of President and Directors of Georgetown College, 331 F.2d 1000 (D.C.Cir. 1964). [refusal of blood transfusion due to religious beliefs as a Jehovah’s Witness]
In re Guardianship of Mikulanec, 356 N.W.2d 683 (Minn.Sup.Ct. 1984). [competency to marry] Taylor v. Garinger, 507 N.E.2d 406 (Ohio App. 1986). [testamentary capacity after legal incompetence]
Blattner v. Blattner, 411 N.W.2d 24 (Minn.App. 1987). [competency to divorce]
In the Matter of Beth Israel Medical Center, 519 N.Y.S.2d 511 (Sup. 1987). [competency to consent to surgery]
Julius Cohen Jeweler v. Succession of Jumon ville, 506 So. 2d 535 (La. App. 1987). [competency to contract to buy jewelry]
In re Milton, 505 N.E.2d 255 (Ohio Sup.Ct. 1987). [treatment refusal due to religious belief in faith healing]
Succession of Sauls, 510 So.2d 715 (La. App. 1987). [testamentary capacity after legal incompetence]
Heights Realty v. Phillips, 749 P.2d 77 (N.M.Sup.Ct. 1988). [competency to sign real-estate-listing contract]
Feiden v. Feiden, 542 N.Y.S.2d 860 (A.D. 1989). [competency to execute deed]
Harper v. Rogers, 387 S.E.2d 547 (Sup.Ct.W.Va. 1989). [competency to execute deed]
loyd v. Jordan, 544 So.2d 957 (Ala.Sup.Ct. 1989). [competency to sign annuity contract]
Weir by Gasper v. Estate of CIAO, 556 A.2d 819 (Sup.Ct.Pa. 1989). [competency to transfer real estate]
Craig v. Perry, 565 So.2d 171 (Ala.Sup.Ct. 1990). [testamentary capacity]
Payne v. Marion General Hospital, 549 N.E.2d 1043 (Ind.App. 1990). [competency to request do not resuscitate order]
In the matter of Romero, 790 P.2d 819 (Sup.Ct.Colo. 1990). [competency to consent to sterilization]
Wilcox v. Willard Shopping Center, 579 A.2d 130 (Conn. App. 1990). [competency to bid on property]
In re Marriage of Davis, 576 N.E.2d 972 (111. App. 1991). [competency to marry]
Pape v. Byrd, 582 N.E.2d 164 (Sup.Ct.Ill. 1991). [competency to marry]
Shoals Ford v. Clardy, 588 So.2d 879 (Ala.Sup.Ct. 1991). [competency of person in manic episode to buy truck]
Syno v. Syno, 594 A.2d 307 (Pa.Super. 1991). [competency to divorce]
Annotation: Power of court or other public agencies, in the absence of statutory authority, to order compulsory medical care for adult, 9 A.L.R.3d 1391.
Annotation: Mental competency of patient to consent to surgical operation or medical treatment, 25 A.L.R.3d 1439.
I. Competency B. Articles and Books
Appelbaum, P. S. (1984). Informed consent. In D. N. Weisstub (Ed.), Law and mental health, Vol. 1, pp. 45–83, New York: Pergamon Press.
Appelbaum, P. S., & Grisso, T. (1988). Assessing patients7 capacities to consent to treatment. New England Journal of Medicine, 319, 1635–1638.
Appelbaum, P. S., & Roth, L. H. (1981) Clinical issues in the assessment of competency. American Journal of Psychiatry, 138, 1462–1467.
Appelbaum, P. S., & Roth, L. H. (1982). Competency to consent to research: A psychiatric overview. Archives of General Psychiatry, 39, 951–958.
Appelbaum, P. S., Lidz, C. W., & Meisel, A. (1987). Informed consent. New York: Oxford University Press.
Berlin, R. M., & Canaan, A. (1991). A family systems approach to competency evaluations in the elderly. Psychosomatics, 32, 349–354.
Collier, M. M. (1990). The mentally deficient witness: The death of incompetency. Law and Psychology Review, 14, 107–137.
Culver, C. M., & Gert, B. (1982). Philosophy in medicine: Conceptual and ethical issues in medicine and psychiatry. New York: Oxford University Press.
Culver, C. M., & Gert, B. (1990). The inadequacy of incompetence. Milbank Quarterly, 68, 619–643.
Cutter, M. A. G., & Shelp, E. E. (Eds.). (1991). Competency: A study of informal competency determinations in primary care. Dordrecht: Kluwer Academic.
Drane, J. F. (1985). The many faces of competency. Hastings Center Report, 15, 17–21.
Draper, R.J., & Dawson, D. (1990). Competence to consent to treatment: A guide for the psychiatrist. Canadian Journal of Psychiatry, 35, 285–289.
Faden, R. F., & Beauchamp, T. L. (1986). A history and theory of informed consent. New York: Oxford University Press.
Gabinet, L. (1986). A protocol for assessing competence to parent a newborn. General Hospital Psychiatry, 8, 263–272.
Gurian, B. S., Baker, E. H., Jacobson, S., Lagerbom, B., & Watts, P. (1990). Informed consent for neuroleptics with elderly patients in two settings. Journal of the American Geriatrics Society, 38, 37–44.
Gutheil, T. G., & Bursztajn, H. (1986). Clinicians’ guidelines for assessing and presenting subtle forms of patient incompetence in legal settings. American Journal of Psychiatry, 143, 1020–1023.
Gutheil, T. G., Bursztajn, H., Kaplan, A. N., & Brodsky, A. (1987). Participation in competency assessment and treatment decisions: The role of a psychiatrist-attorney team. Mental and Physical Disability Law Reporter, 11, 446–449.
Hoffman, B. F., & Srinivasan, J. (1992). A study of competence to consent to treatment in a psychiatric hospital. Canadian Journal of Psychiatry, 37, 179–182.
Kaplan, K. H., & Price, M. (1989). The clinician’s role in competency evaluations. General Hospital Psychiatry, 11, 397–403.
Kapp, M. B. (1985). Geriatrics and the law: Patient rights and professional responsibilities. New York: Springer.
Lidz, C. W., Meisel, A., Zerubavel, E., Carter, M., Sestak, R. M., & Roth, L. H. (1984). Informed consent: A study of decisionmaking in psychiatry. New York: Guilford Press.
McCrary, S. V., & Walman, A. T. (1990). Procedural paternalism in competency determination. Law, Medicine, and Health Care, 18, 108–113.
McKinnon, K., Cournos, F., & Stanley, B. (1989). Rivers in practice: Clinicians’ assessments of patients’ decision-making capacity. Hospital and Community Psychiatry, 40, 1159–1162.
Melnick, V. L., & Dubler, N. M. (Eds.). (1985). Alzheimer’s dementia: Dilemmas in clinical research. Clifton, NJ: Humana Press.
Pavlo, A. M., Bursztajn, H., & Gutheil, T. G. (1987). Christian Science and competence to make treatment choices: Clinical challenges in assessing values. International Journal of Law and Psychiatry, 10, 395–401.
Pavlo, A. M., Bursztajn, H., Gutheil, T. G., & Levi, L. M. (1987). Weighing religious beliefs in determining competence. Hospital and Community Psychiatry, 38, 350–352.
Rosner, R., & Schwartz, H. I. (Eds.). (1987). Geriatric psychiatry and the law. New York: Plenum Press.
Roth, L. H., Meisel, A., & Lidz, C. W. (1977). Tests of competency to consent to treatment. American Journal of Psychiatry134, 279–284.
Rozovsky, F. A. (1990). Consent to treatment: A practical guide (2nd ed.). Boston: Little, Brown.
Saks, E. R. (1991). Competency to refuse treatment. North Carolina Law Review, 69, 945–999.
Schwartz, H. I., & Blank, K. (1986). Shifting competency during hospitalization: A model for informed consent decisions. Hospital and Community Psychiatry, 37, 1256–1260.
Spar, J. E., & Garb, A. S. (1992). Assessing competency to make a will. American Journal of Psychiatry, 149, 169–174.
Spaulding, W. J. (1985). Testamentary competency. Law and Human Behavior, 9, 113–139.
Stanley, B., Stanley, M., Guido, J., & Garvin, L. (1988). The functional competency of elderly at risk. Gerontologist, 28 (Suppl), 53–58.
Stone, A. (1979). Informed consent: Special problems for psychiatry. Hospital and Community Psychiatry, 30, 321–327.
II. Guardianship and Substituted Decision Making A. Cases
Vecchione v. Wohlgemuth, 426 F.Supp. 1297 (E.D.Pa. 1977); 558 F.2d 150 (3rd Cir. 1977).
Estate of Early, 673 P.2d 209 (Sup.Ct. Cal. 1983).
In re Gardner, 459 N.E.2d 17 (Ill.App. 1984).
In the Matter of the Guardianship of Opal Ingram, 689 P.2d 1363 (Wash.Sup.Ct. 1984). [court approval needed for amputation]
Pace v. Pace, 513 N.E.2d 1357 (Ohio App. 1986).
Detzel v. Detzel, 521 N.Y.S.2d 6 (A.D. 1987).
In the Matter of the Guardianship of K.N.K., 407 N.W.2d 281 (Wis.App. 1987).
In re Guardianship of Osterman, 515 So.2d 1066 (Fla.App. 1987).
Werner v. Wright, 737 S.W.2d 761 (Mo.App. 1987).
In re Conservatorship of Goodman, 766 P.2d 1010 (Okla.App. 1988).
In re Conservatorship of Estate of Martin, 421 N.W.2d 463 (Neb.Sup.Ct. 1988). [“prudent man” proxy decision-making standard]
In re Interdiction of Thomas, 535 So.2d 1315 (La.App. 1988).
Wahlenmaier, v. Wahlenmaier, 762 S.W.2d 575 (Tex.Sup.Ct. 1988). [guardian’s right to obtain divorce for ward]
In re Bailey, 771 S.W.2d 779 (Ark.Sup.Ct. 1989).
Commonwealth of Pennsylvania v. Bean, 558 A.2d 170 (Pa.Cmwlth. 1989).
Goldman v. Krane, 786 P.2d.437 (Colo.App. 1989).
Hill v. Jones, 773 S.W.2d 55 (Tex.Ct.App. 1989).
Pate v. Bobo, 540 So.2d 660 (Sup.Ct.Ala. 1989).
In re Lundgaard, 453 N.W.2d 58 (Minn.App. 1990).
Bryan v. Hölzer, 589 So.2d 648 (Sup.Ct.Miss. 1991). [fraud by conservator]
In the Matter of Grinker, 573 N.E.2d 536 (N.Y.Ct.App. 1991). [conservator may not commit ward to nursing home]
In the Matter of Estate of Logan, 815 P.2d 35 (Idaho App. 1991). [guardian’s failure to keep records]
Guardianship of Doe, 583 N.E.2d 1263 (Mass.Sup.Jud.Ct. 1992). [terminate feeding and hydration from never competent person]
Annotation: Effect of guardianship of adult on testamentary capacity, 89 ALR 2d 1120.
Annotation: Validity of guardianship proceeding based on brainwashing of subject by religious, political, or social organization, 44 ALR 4th 1207.
II. Guardianship and Substituted Decision Making B. Articles and Books
American College of Physicians. (1989). Cognitively impaired subjects. Annals of Internal Medicine, 111, 843–848.
Anderer, S. J. (1990). Determining competency in guardianship proceedings. Washington, DC: American Bar Association.
Apolloni, T., & Cooke, T. P. (1984). A new look at guardianship. Baltimore: Brookes.
Applegate, W. B. (1987). Use of assessment instruments in clinical settings. Journal of the American Geriatric Society, 35, 45–50.
Areen, J. (1987). The legal status of consent obtained from families of adult patients to withhold or withdraw treatment. Journal of the American Medical Association, 258, 229–235.
Axilbund, M. T. (1979). Substituted judgment for the disabled: Report of an inquiry into limited guardianship, public guardianship and adult protective services in six states. Washington, DC: Commission on the Mentally Disabled, American Bar Association.
Barnes, A. P. (1988). Florida guardianship and the elderly: The paradoxical right to unwanted assistance. University of Florida Law Review, 40, 949–988.
Brown, R. N. (1989). The rights of older persons. Carbondale: Southern Illinois University Press.
Buchanan, A. E., & Brock, D. W. (1989). Deciding for others: The ethics of surrogate decision making. Cambridge: Cambridge University Press.
Cairl, R. E., Pfeiffer, E., Keller, D. M., Burke, H., & Samis, H. V. (1983). An evaluation of the reliability and validity of the Functional Assessment Inventory. Journal of the American Geriatric Society, 31, 607–612.
Casasanto, M. D., Covert, S. B., Saunders, A. G., & Simon, M. M. (1987). Individual functional assessment: An instruction manual. Mental and Physical Disability Law Reporter, 11, 60–90.
Commission on Legal Problems of the Elderly American Bar Association. (1986). Statement of recommended judicial practices. Washington, DC: American Bar Association.
Commission on the Mentally Disabled, Commission on Legal Problems of the Elderly, American Bar Association. (1989). Guardianship: An agenda for reform. Washington, DC: American Bar Association.
Denton, P. (1988). Assessing the patient’s functional performance. Hospital and Community Psychiatry, 39, 935–936.
Emanuel, E. J., & Emanuel, L. L. (1992). Proxy decision making for incompetent patients. Journal of the American Medical Association, 267, 2067–2071.
Friedman, L., & Savage, M. (1988). Taking care: The law of conservatorship in California. Southern California Law Review, 61, 273–290.
Frolik, L. A. (1981). Plenary guardianship: An analysis, a critique, and a proposal for reform. Arizona Law Review, 23, 599–660.
George, L. K., & Fillenbaum, G. G. (1985). OARS methodology: A decade of experience in geriatric assessment. Journal of the American Geriatric Society, 33, 607–615.
Grisso, T. (1986). Evaluating competencies: Forensic assessments and instruments. New York: Plenum Press.
Gutheil, T. G., & Appelbaum, P. S. (1985). The substituted judgment approach: Its difficulties and paradoxes in mental health settings. Law, Medicine, and Health Care, 13, 61–64.
Hafemeister, T. L., & Sales, B. D. (1982). Responsibilities of psychologists under guardianship and conservatorship laws. Professional Psychology, 13, 354–371.
Hafemeister, T. L., & Sales, B. D. (1984). Interdisciplinary evaluations for guardianships and conservatorships. Law and Human Behavior, 8, 335–354.
High, D. M., & Turner, H. B. (1987). Surrogate decision making: The elderly’s familial expectations. Theoretical Medicine, 8, 303–320.
Iris, M. A. (1988). Guardianship and the elderly: A multi-perspective view of the decisionmaking process. Gerontologist, 28 (Suppl), 39–45.
Jecker, N. S. (1990). The role of intimate others in medical decision making. Gerontologist, 30, 65–71.
Lamb, H. R., & Weinberger, L. E. (1992). Conservatorship for gravely disabled psychiatric patients: A four-year follow-up study. American Journal of Psychiatry, 149, 909–913.
Lichtenberg, P. A., & Strzepek, D. M. (1990). Assessments of institutionalized dementia patients’ competencies to participate in intimate relationships. Gerontologist, 30, 117–120.
Massad, P., & Sales, B. (1981). Guardianship: An acceptable alternative to institutionalization? American Behavioral Scientist, 24, 755–767.
New York State Task Force on Life and the Law. (1992). When others must choose: Deciding for patients without capacity. New York: Author.
Nolan, B. S. (1984). Functional evaluation of the elderly in guardianship proceedings. Law, Medicine, and Health Care, 12, 210–218.
Parry, J. (1987). A unified theory of substitute consent: Incompetent patients’ right to individualized health care decision making. Mental and Physical Disability Law Reporter, 11, 378–441.
Parsons, R. J., & Cox, E. O. (1989). Family medication in elder caregiving decisions: An empowerment intervention. Social Work, 34, 122–126.
Peters, R., Schmidt, W. C, & Miller, K. S. (1985). Guardianship of the elderly in Tallahassee, Florida. Gerontologist, 25, 532–538.
Pfeiffer, E., Johnson, T. M., & Chiofolo, R. C. (1981). Functional assessment of elderly subjects in four service settings. Journal of the American Geriatric Society, 29, 433–437.
Pleak, R. R., & Appelbaum, P. S. (1985). The clinician’s role in protecting patient’s rights in guardianship proceedings. Hospital and Community Psychiatry, 36, 77–79.
Rhoden, N. K. (1988). Litigating life and death. Harvard Law Review, 102, 375–446.
Robinson, B. E., Lund, C. A, Keller, D., & Cuervo, C. A. (1986). Validation of the Functional Assessment Inventory against a multidisciplinary home care team. Journal of the American Geriatric Society, 34, 851–854.
Schmidt, W. C., & Peters, R. (1987). Legal incompetents’ need for guardians in Florida. Bulletin of the American Academy of Psychiatry and the Law, 15, 69–83.
Schmidt, W. C, Miller, K. S., Bell, W. G., & New, B. G. (1981). Public guardianship and the elderly. Cambridge, MA: Ballinger.
Seckler, A. B., Meier, D. E., Mulvihill, M. & Paris, B. E. C. (1991). Substituted judgment: How accurate are proxy predictions? Annals of Internal Medicine, 115, 92–98.
Solomon, D. (1988). National Institutes of Health Consensus Development Conference Statement: Geriatric assessment methods for clinical decision making. Journal of the American Geriatric Society, 36, 342–347.
Steinberg, R. M. (1985). Alternative approaches to conservatorship and protection of older adults referred to public guardian. Los Angeles: Andrus Gerontology Center, University of Southern California.
Tomlinson, T., Howe, K., Notman, M., & Rossmiller, D. (1990). An empirical study of proxy consent for elderly persons. Gerontologist, 30, 54–64.
Warren, J. W., Sobal, J., Tenney, J. H., Hoopes, J. M., Damron, D., Levenson, S., DeForge, B. R., & Muncie, H. L. (1986). Informed consent by proxy: An issue in research with elderly persons. New England Journal of Medicine, 315, 1124–1128.
Wettstein, R. M., & Roth, L. H. (1988). The psychiatrist as legal guardian. American Journal of Psychiatry, 145, 600–604.
III. Elder Abuse and Protective Services
Council on Scientific Affairs, American Medical Association. (1987). Elder abuse and neglect. Journal of the American Medical Association, 257, 966–971.
Daniels, R. S., Baumhover, L. A., & Clark-Daniels, C. L. (1989). Physicians’ mandatory reporting of elder abuse. Gerontologist, 29, 321–327.
Filinson, R., & Ingman, S. R. (Eds.). (1989). Elder abuse: Practice and policy. New York: Human Sciences Press.
Kapp, M. B. (1983). Adult protective services: Convincing the patient to consent. Law, Medicine, and Health Care, 11, 163–188.
Kosberg, J. I. (Ed.). (1983). Abuse and maltreatment of the elderly: Causes and interventions. Boston: John Wright.
Pillemer, K., & Finkelhor, D. (1988). The prevalence of elder abuse: A random sample survey. Gerontologist, 28, 51–57.
Quinn, M. J., & Tomita, S. K. (1986). Elder abuse and neglect: Causes, diagnosis, and intervention strategies. New York: Springer.
Salend, E., Kane, R. A., Satz, M., & Pynoos, J. (1984). Elder abuse reporting: Limitations of statutes. Gerontologist, 24, 61–69.
IV. Advance Directives A. Cases
Barber v. Superior Court, 195 Cal.Rptr. 484 (1983).
Bartling v. Superior Court, 209 Cal.Rptr. 220 (App. 1984).
John F. Kennedy Memorial Hospital v. Bludworth, 452 So.2d 921 (Fla. 1984).
In Re Conroy, 486 A.2d 1209 (NJ.Sup.Ct. 1985).
Saunders v. State, 492 N.YS.2d 510 (Sup.Ct. 1985).
Cruzan v. Missouri Department of Health, 110 S.Ct. 2841 (1990).
IV. Advance Directives B. Articles and Books
Alexander, G. J. (1988). Writing a living will using a durable power of attorney. New York: Praeger.
Choice in Dying. (1992). Refusal of treatment legislation: A compilation of state statutes. New York: Author.
Clifford, A. D. (1987). Simple will book: How to prepare a legally valid will. Berkeley: Nolo Press.
Davidson, K. W., Hackler, C, Caradine, D. R., & McCord, R. S. (1989). Physicians’ attitudes on advance directives. Journal of the American Medical Association, 262, 2415–2419.
Emanuel, L. L., & Emanuel, E. J. (1989). The medical directive: A new comprehensive advance care document. Journal of the American Medical Association, 261, 3288–3293.
High, D. M. (1987). Planning for decisional incapacity: A neglected area in ethics and aging. Journal of the American Geriatrics Society, 35, 814–820.
King, N. (1991). Making sense of advance directives. Dordrecht: Kluwer Academic Publishers.
Legal Counsel for the Elderly. (1987). Decision making, incapacity, and the elderly: A protective services manual. Washington, DC: American Association of Retired Persons.
Meisel, A. (1989 & Suppl.). The right to die. New York: Wiley.
Moore, D. L. (1986). The durable power of attorney as an alternative to the improper use of conservatorship for health-care decisionmaking. St. Johns’s Law Review, 60, 631–673.
Ouslander, J. G., Tymchuk, A. J., & Rahbar, B. (1989). Health care decisions among elderly long-term care residents and their potential proxies. Archives of Internal Medicine, 149, 1367–1372.
Overman, W., & Stoudemire, A. (1988). Guidelines for legal and financial counseling of Alzheimer’s disease patients and their families. American Journal of Psychiatry, 145, 1495–1500.
President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. (1983). Deciding to forego life-sustaining treatment. Washington, DC: U.S. Government Printing Office.
Roe, J. M., Goldstein, M. K., Massey, K., & Pascoe, D. (1992). Durable power of attorney for health care. Archives of Internal Medicine, 152, 292–296.
Schneiderman, L. J. (1985). Counseling patients to counsel physicians on future care in the event of patient incompetence. Annals of Internal Medicine, 102, 693–698.
Soled, A. J. (1988). The essential guide to wills, estates, trusts, and death taxes. Glenview, IL: Scott Foresman.
U.S. Congress, Office of Technology Assessment. (1987). Life-sustaining technologies and the elderly. Washington, DC: U.S. Government Printing Office.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 1993 Springer Science+Business Media New York
About this chapter
Cite this chapter
Weiner, B.A., Wettstein, R.M. (1993). Competency and Guardianship. In: Legal Issues in Mental Health Care. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-1654-9_9
Download citation
DOI: https://doi.org/10.1007/978-1-4899-1654-9_9
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4899-1656-3
Online ISBN: 978-1-4899-1654-9
eBook Packages: Springer Book Archive