Protecting the incapable–Interdiction of in-patients in centro hospitalar De São João in the last two years

Abstract

IntroductionThe interdiction of citizens is embodied in the Portuguese civil code and is untouched since 1966 regardless of the profound changes in our society. In 2006, Centro Hospitalar de São João (CHSJ) created protective measures for inpatients that are incapable; the procedure encompasses multidisciplinary evaluation of patients and the elaboration of a final report by liaison psychiatrists.ObjectivesTo describe the interdiction proceedings initiated at CHSJ in the last two years, establishing parallels with our socio-demographical and epidemiological reality.MethodsRetrospective study of the internal requests for psychiatric consultation concerning interdiction proceedings made in the CHSJ from January 2015 to December 2016.ResultsDuring the study period, the liaison psychiatry service received 37 requests for evaluation of patients’ decision-making capacity through the internal consultation system. The typology of the patient targeted in the interdiction process is male, more than 70 years old, hospitalized due to infectious intercurrences whose dependency of others enables him to return to his residence. More than a half (51%) of the requests were performed by internal medicine services. Twenty-one reports declaring the patient's inability to govern his person and property were made. The most common pathology underlying this cognitive impairment was dementia (57%).ConclusionOur results reflect the aging of Portuguese population and the increased prevalence of dementia. The evaluation of the capacity for self-governance will be increasingly required in our clinical practice and demands a holistic approach to the patient while taking into account the preservation of his autonomy, dignity and rights.Disclosure of interestThe authors have not supplied their declaration of competing interest.