Treatment Decision-Making Capacity in Forensic vs Non-forensic Psychiatric Patients: A European Comparison

Abstract Background Consent to treatment is a cornerstone of medical ethics and law. Nevertheless, very little empirical evidence available inform clinicians policymakers regarding the capacities forensic patients with schizophrenia spectrum disorders (SSDs) make decisions about their treatment, risk clinical legal inertia, silent coercion, stigmatization, or ill-conceived reforms. Study Design In this multinational study, we assessed compared treatment-related decisional in non-forensic SSD. 160 139 were used Austria, Germany, Italy, Poland, England. Their capacity consent was by means MacArthur Competence Assessment Tool for Treatment (MacCAT-T). Multiple generalized linear regression models identify socio-demographic variables associated MacCAT-T scores. Results total, 55 (34.4%) 58 (41.7%) showed high capacity, defined as scoring ≥75% maximum scores understanding, appreciation reasoning, 2 expressing choice. Forensic differences across countries. Of all variables, only “social support” directly relevant policy. Conclusions have comparable counterparts. Social contacts might provide substantial contribution towards enhancing autonomy both patients, hence improving overall quality legitimacy mental health care.