Page 3 - May 2017

Not Just an Ob-Gyn Anymore:

Securing Informed Consents from Mentally Ill Patients

Approximately one-third of American women list their obstetrics and gynecology and their consequences, the patient must have all
provider (ob -gyn) as their primary physician. Ob-gyns serve a wide range of information related to the examination and procedure,
women's health needs and serve as a transitional gateway during the critical onset the patient's participation must be voluntary, and the
of mental issues. Due in part to our changing healthcare system, both pre and post- ob-gyn must be assured of the patient's competency
Obama Care, there has also been a noticeable diminishment of services for mental and ability to understand the treatment.
treatment, and many women are adding responsibilities to ob-gyns by using them Consequently, assessing whether a patient who suf-
as the primary care providers and first responders for psychological treatment. fers from mental illness has decision-making capacity
With mental illnesses being 2 to 3 times more prevalent in women that in men, is critical to determining whether she can consent to BY LIZ C. MESSIANU,
ob-gyns must be equipped with the proper guidance to treat women with mental treatment and give informed consent. ESQ.
disabilities. Below are some simple steps that a practitioner can
Mental illness in the United States is growing at an alarming rate. The National take to ensure that your practice is protected:
Survey on Drug Use and Health 2012 Report, estimated that the percentage of adults • Has the patient's intake questionnaire been updated to inquire as to mental ill-
with mental illness (excluding substance use) was 18.6% among adults. With this ness and current psychotropic medications patient is currently taking?
alarming statistic, it is paramount that ob-gyns create and implement a mechanism • Has the patient given consent for the ob-gyn to discuss their chart with the
to screen for mental illness in patients in order to avoid medical malpractice, avoid patient's psychiatrist?
obtaining unauthorized consents to medical treatments and having an incapacitated • Does the patient have a primary care physician, and if not, has there been a sug-
individual signing contracts for services. Ob-gyns need to take preventive steps that gestion to have one or a referral?
will enable them to adequately treat patients with mental disabilities, while simul- • Does the patient have the capacity to sign intake forms and contract for servic-
taneously protect them from legal suits for failure to obtain informed consents from es?
patients. • If the patient acts incoherent or has listed they are taking psychotropic drugs,
Incapacity and mental illness, terms which are mistakenly used interchangeably, has a diligent search been made to determine if patient is guardianship or conserva-
have very different meanings. Incapacity (defined differently by State) refers to a torship?
judicial determination that a person lacks the capacity to manage at least some of • Is the patient capable of giving consent by demonstrating that she understands
the person's property or to meet at least some of the person's essential health and her healthcare decisions and their potential consequences?
safety requirements. For a patient to be incompetent, she must have been adjudicat- While no single criterion can be used to determine if a patient has serious mental
ed by a Court that she is incompetent in some respect. In turn, a patient can suffer illness or diminished mental capacity, and a patient may be functional in many
from mental illness yet be competent. When a new patient signs the initial intake aspects, yet be unable to engage in the complex decision, then they cannot give the
forms and "consents" to medical treatments during a period where she was not able required medical consent to sign intake forms.
to understand the nature of what she has consented to or signed, those intake forms
can be set aside and voided, if the right steps are not taken. Liz Messianu, Esq., Partner, Lubell Rosen, LLC, can be reached
Ob-gyns must obtain informed consent for treatments or procedures from men- at (305) 442-9046 or lcm@lubellrosen.com.
tally challenged patients. Informed consent requires an understanding of decisions

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