Jel,
On our assessment form there are three areas evaluated: threat of
violence, suicide risk and competence. As Adrian points out these three
areas are independent. There are four aspects to assessing competence -
feeling suicidal is not one of them. The assessment form will soon be
downloadable from the new 'Shared Resources' section of the CEM Website.
Tim.
PS. Ffion Davies designed the system and developed the form with Trevor
Freedman our liaison psych. I can claim no credit myself.
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Adrian Fogarty
Sent: 18 August 2006 08:39
To: [log in to unmask]
Subject: Re: Psychiatric patients leaving the emergency department
I don't think Tim meant that, to be fair. He was simply saying that
competence - in general - ideally should be assessed early on. But I
agree that suicidal ideation, per se, does not equate to incompetence.
And I agree that many people use suicidal ideation - incorrectly - as a
surrogate for incompetence.
Julian, I suspect Tim's offer is a good way forward. I seem to recall
the South Yorkshire coroner is very high profile, rarely out of the news
since Shipman etc. Not a man to mess about with!
AF
----- Original Message -----
From: "Jel Coward" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, August 18, 2006 4:08 AM
Subject: Re: Psychiatric patients leaving the emergency department
> Coats Tim - Professor of Emergency Medicine wrote:
>> First decision is whether or not patient is competent to take their
>> own decisions.
>
> ahh, but should we use those 'decisions' as an indicator of whether
> the patient is competent to make their own decisions.
>
> My point being that a decision to end one's own life might be made by
> a fully competent person - and that intent alone, perhaps, should not
> be used to rule them incompetent .....but it is often used to do that,
> in my experience.
>
> A difficult area.
>
> Regards all
>
>
> Jel
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