In a previous post, we began speaking about psychiatric advance directives, which are documents outlining the preferences of mental health patients in terms of medical care. These documents, now in use in various states, give those with mental health conditions the opportunity to better control how they are cared for in times of crisis, when they are no longer competent to make decisions.
Loss of competence is, of course, the major contingency upon which regular advance directives are based. Both advance directives and psychiatric advance directives have as their basic goal to give patients the opportunity to express their wishes in terms of medical care. Competence, however, is somewhat of a tricky issue when it comes to psychiatric advance directives.
A person who establishes an advance directive must be competent in order for the document to be valid. In addition, the advance directive may be used for medical decisions only when the patient is not competent to make decisions for him- or herself. Whether or not a patient is competent is not always easy to determine, and different states have different approaches to making that determination.
Other important issues are the use of psychiatric advance directives for refusal of all treatment and the revocation of advance directives.
At present, only twelve states official recognize psychiatric advance directives, and Georgia is not one of them. There is, however, a House bill to be considered this legislative session that would provide for the use of psychiatric advance directives in Georgia. It will be interesting to see whether the bills gains support.
Source: Med City News, “Psychiatric advance directives: More patients engagement, better outcomes,” Salasky, Prue, June 10, 2013.