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OtherCASE REPORTS

Temporal competency in catatonia

JM Bostwick and JP Chozinski
Journal of the American Academy of Psychiatry and the Law Online September 2002, 30 (3) 371-376;
JM Bostwick
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JP Chozinski
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Abstract

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.

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Journal of the American Academy of Psychiatry and the Law Online: 30 (3)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 30, Issue 3
1 Sep 2002
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Temporal competency in catatonia
JM Bostwick, JP Chozinski
Journal of the American Academy of Psychiatry and the Law Online Sep 2002, 30 (3) 371-376;

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Temporal competency in catatonia
JM Bostwick, JP Chozinski
Journal of the American Academy of Psychiatry and the Law Online Sep 2002, 30 (3) 371-376;
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