Abstract
Recent developments in the legal regulation of psychiatric care have increased the frequency with which clinicians may become involved in guardianship proceedings. Most prominent among these developments have been court decisions requiring that guardians-not family members or physicians-provide proxy consent to treatment on behalf of incompetent psychiatric patients (1,2). At the same time, growing interest in geriatric psychiatry has increased the number and visibility of patients who may need a guardian to make decisions about their property or persons (3). The increased prominence of guardianship proceedings has created some difficult dilemmas for clinicians. Hospital and clinic staff are often in the position of initiating or encouraging family members to initiate the guardianship process. Such actions may put clinicians in an oppositional stance relative to their patients, who may resist the idea that they are incompetent to make decisions for them-
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