TY  - JOUR
TI  - Comparison of emergency department and 
psychiatry physicians’ views on decisionmaking capacity cases in the grey zone
AB  - Objective: The aim of this study is to demonstrate the 
level of reconciliation between different medical branches, decision-making processes over the same facts, 
both among themselves and with others. Method: An 
online survey was created with three cases and six questions in the grey area related to the decision-making 
capacity (DMC) situations. Surveys were sent to participants through their e-mails registered in hospital systems. A total of 165 physicians participated in the study. 
The first scenario concerned an unstable patient with 
gastrointestinal bleeding and major depression requesting discharge despite medical advice. The second scenario included the discharge request of a patient who 
was on the border of pulmonary insufficiency with a 
severe asthma attack. The final scenario was about a 
homeless person with chest pain that occurred at the 
time of alcohol withdrawal, demanding discharge, at a 
point where a heart attack wasn’t excluded. Results:
54% of psychiatry specialists, 77% of psychiatry residents, 82% of emergency medicine specialists and 76% 
of emergency medicine residents stated that DMC was 
intact for scenario 1. For scenario 2, these rates were 
determined as %88, %90, %76, %71 while for scenario 3 
they were %44, %35, %44 and 47%, respectively. 
Among the psychiatrists and residents, a statistically significant difference was found between the two groups 
only in scenario 1. Discussion: : Consistent with the literature, it was observed that the interrater agreement 
of DMC decisions between different medical branches 
was low. Differences can be explained by different experience years, educational differences, evaluating basic 
decision-making competencies with different degrees of 
importance and differences in malpractice concerns.
AU  - Altınöz, Ali Ercan
AU  - ALTINÖZ, Şengül Tosun
AU  - Olcay SONKURT, Harun
DO  - 10.5505/kpd.2022.13245
PY  - 2022
JO  - Klinik Psikiyatri Dergisi
VL  - 25
IS  - 2
SN  - 1302-0099
SP  - 177
EP  - 183
DB  - TRDizin
UR  - http://search/yayin/detay/514277
ER  -