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A Theory and a Retrospective Study

Michael P. Alexander, MD

Arch Neurol. 1988;45(1):23-26.

Abstract
• In an attempt to establish a method for determination of mental competence, a two-part investigation was undertaken. First, a model for mental competence was devised that would be applicable across a broad range of neurologic disorders; this model was based on a patient's ability to make complex decisions. Second, a retrospective analysis of competence in 92 inpatients on a neurobehavioral service was carried out. The model was useful way to view competence, at least in this population. Competence could be classified as operational, limited to a single cognitive domain, or as general, cutting across all domains in a way for which no compensation could be devised. The results suggest that a model of competence based on analysis of individual congnitive operations will provide a sound clinical approach to a common problem that is presently not well characterized.

Author Affiliations
From the Aphasia Program, Braintree (Mass) Hospital, and the Department of Neurology, Boston University School of Medicine.

Footnotes
Accepted for publication Sept 3, 1987.

Reprint requests to Aphasia Program, Braintree Hospital, 250 Pond St, Braintree, MA 02184 (Dr Alexander).

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