RT Journal Article SR Electronic T1 Psychiatric and Clinical Sequelaeof Delirium and Competenceto Stand Trial JF Journal of the American Academy of Psychiatry and the Law Online JO J Am Acad Psychiatry Law FD American Academy of Psychiatry and the Law SP 549 OP 551 VO 37 IS 4 A1 Anasuya Salem A1 Cecilia Leonard YR 2009 UL http://jaapl.org/content/37/4/549.abstract AB We present the case of a middle-aged defendant who had been incarcerated in a county jail and housed on the mental health unit. It was documented that he had been exhibiting fluctuating levels of alertness and responsiveness. The writers saw him in a forensic capacity, to conduct an evaluation of his competence to stand trial, and recognized that he was having a medical emergency, delirium that was most likely due to brain metastases from inoperable advanced cancer. We recommended an immediate transfer to a medical facility for treatment. The article serves to present an interesting case and to highlight the need for clinical vigilance despite the usual goal of an objective, noninterfering forensic role.