Assessment of the capacity to express informed consent for organ donation in patients with schizophrenia

Maria Civita De Marco, Gabriele Sani, Giovanni Manfredi, Isabella Pacchiarotti, Valeria Savoja, Andrea Balbi, Lorenzo Mazzarini, Adriana Borriello, Giorgio D. Kotzalidis, Roberto Tatarelli, Paolo Girardi, Stefano Ferracuti

Research output: Contribution to journalArticlepeer-review

Abstract

In Italy, the "silent-consent" principle of donor's willingness regulates organ donation for postmortem transplantation, but civil incompetence excludes it. We investigated decisional capacity for organ donation for transplantation of 30 controls and 30 nonincompetent patients with schizophrenia as related to clinical symptoms, cognition, and functioning. Assessments were carried out through the Competence for Donation Assessment Scale (CDAS), Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms, Life Skills Profile (LSP), Raven's Colored Progressive Matrices (RCPM), Wisconsin Card Sorting Test, Rey RI, Rey RD, and Visual Search. Patients and controls differed on the CDAS Understanding and Choice Expression areas. Patients showed significant inverse bivariate correlations between CDAS Understanding and scores on total BPRS, LSP self-care scale, and RCPM cognitive test. Our results show that decisional capacity for participating in research does not predict decisional capacity for postmortem organ donation in patients with schizophrenic or schizoaffective psychosis; hence, before judging consent for donation, patients must be provided with enhanced information to better understand this delicate issue.

Original languageEnglish
Pages (from-to)669-676
Number of pages8
JournalJournal of Forensic Sciences
Volume55
Issue number3
DOIs
Publication statusPublished - May 2010

Keywords

  • Ethics
  • Forensic science
  • Informed consent
  • MacArthur Competence Assessment Tool for Treatment
  • Organ donation
  • Schizophrenia
  • Transplantation

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Genetics
  • Medicine(all)

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