Informed consent in psychiatry
The medical treatment agreement is soon going to be discussed in the Second Chamber of the Dutch government. One of the most important subjects is the informed consent. Applied to the psychiatric field, heaps of problems arise.
There is a battle going in the literature, whether this realization of the basic rights is an improvement of the health care rather than a strict juridical fiction.
At any rate there is a question of a paradox that the most serious patient for whom the i.c. is most necessary, is least capable of giving consent: namely information ought to be given and to be understood and a patient should be capable to make a choice.
Discussed is that each of these points will be accompanied by a lot of problems.
In any case i.c. is never an event that takes place only once, but it is rather a process in the course of time.
A number of suggestions is given how to deal with this problem. For an important group of psychiatric patients i.c. remains in the `by proxy' form too, almost impossible.