PT - JOURNAL ARTICLE AU - Bostwick, JM AU - Chozinski, JP TI - Temporal competency in catatonia DP - 2002 Sep 01 TA - Journal of the American Academy of Psychiatry and the Law Online PG - 371--376 VI - 30 IP - 3 4099 - http://jaapl.org/content/30/3/371.short 4100 - http://jaapl.org/content/30/3/371.full SO - J Am Acad Psychiatry Law2002 Sep 01; 30 AB - A catatonic patient without known relatives or advance directives faced possible death without electroconvulsive treatment (ECT). The authors describe using medication to restore capacity to permit the patient to give critical history and consent to potentially life-saving treatment. Even had a proxy been available, the jurisdiction in which he fell ill forbade substituted judgment for ECT, permitting only recipients themselves to consent. While emergent ECT was not specifically forbidden in this jurisdiction, a full curative course presumably could not have been administered without some form of consent. THus, the intervention prevented a treatment delay while the court was petitioned and also avoided having to insert a judge into the doctor-patient relationship. This case focuses on a specific condition, medication, and jurisdiction, but it outlines a general paradigm of pharmacologic intervention to restore temporary capacity. We encourage physicians to identify situations in which medication can create temporary "lucid intervals," thereby restoring patient autonomy and self-determination that would otherwise be lost to proxies or courts of law.