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June 28, 2000

Cardiovascular Procedures in Patients With Mental Disorders

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;283(24):3198-3199. doi:10.1001/jama.283.24.3198

To the Editor: Dr Druss and colleagues1 allude to the fact that patients with mental disorders may have difficulty making decisions about the appropriateness of diagnostic tests and interventional procedures. They failed to mention that the major difficulty in treating patients who have serious mental disorders is obtaining informed consent. Patients with the most severe mental disorders often have court-appointed guardians or family members who are responsible for their care. In this litigious society, the performance of invasive procedures without carefully defined and informed consent is potentially hazardous both to the physician and the patient. There can be little doubt that one of the major reasons for a decreased incidence of the performance of these procedures is the simple inability to obtain a properly executed informed consent for the procedure.