BMJ 1995;310:1605 (17 June)

Letters

Incompetence develops gradually

EDITOR,--Incompetence is not an all or nothing issue (as the Law Commission recognises).1 Dementia may cause a gradual erosion of competence, and it might be difficult to decide at what point a patient lost the ability to revoke an earlier advance directive. This can be covered in a properly framed law, but we must be vigilant to make sure that the law is properly framed and that doctors are not made to face unnecessary and impossible moral and ethical dilemmas by an oversimplistic approach.

Consultant in psychiatry for older adults Leeds Community and Mental Health Services, Leeds LS10 2TP

John P Wattis 

  1. Doyal L. Advance directives. BMJ 1995;310:612-3. (11 March.) [Free Full Text]

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