Family process and legal guardianship for the psychiatric patient: a clinical study.

In grappling with the problem of the incompetent psychiatric in-patient who needs but refuses treatment, legal authorities have often turned to legal guardianship-a special case of substituted judgment-as a solution. A number of contemporary legal cases l a have turned upon the issue of substituted judgment, while a number of articles in the professional literature48 have addressed the problems-legal, clinical, ethical and logistical-inherent in the guardianship process. To our knowledge, however, there exists no clinical study of the impact on family functioning created by the clinical need for appointment of a guardian for an incompetent family member who is a psychiatric in-patient. This study attempts to address this void in clinical data by surveying the effects of the guardianship procedure on family process.