Boston Bombing Suspect – Is He Competent for Legal Proceeding in ICU?

In the continuing case of the Boston bombing suspect Tsarnaev, news organizations today report that a legal proceeding was held in his ICU room with a magistrate, federal prosecutors, and defense attorneys. The patient was read his rights by the magistrate in Beth Israel Deaconess Hospital and was given the charges against him. While we are not attorneys, it is important and interesting to note that if the proceeding planned was an upcoming medical one and not a legal one, the patient would almost certainly not meet the requirements for competency, consent, and capacity to make a decision that would allow the procedure to proceed. A chief reason is that the patient is no doubt under or has recently been under the effects of narcotics and benzodiazepines. Consent can be obtained only from a patient, legal guardian, or advocate who is “competent.” Competency is a legal matter. It is a determination made by a court of law that an individual has the requisite abilities to make certain decisions such as those pertaining to medical care, daily aspects of life, personal finances, etc. It follows that a patient who has taken or been given mind-altering drugs (i.e., anxiolytics or narcotics) or who is in significant pain may not be able to give a valid consent. One common mistake in obtaining consent and assessing competency is to confuse competency with capacity for decision making. Capacity for decision making in contrast to competency is a clinical determination. There...
Source: Inside Surgery - Category: Surgeons Authors: Tags: Musings boston bomb suspect capacity competent ICU magistrate miranda read rights read ro Source Type: blogs