Of Competence, Mental Health, Insanity Defense and Medical Record Evaluation

by | Published on Apr 1, 2015 | Medical Record Review

A report on NOLA.com “Tom Benson medical records to remain secret in New Orleans competency case” brings to mind certain issues that surround the legal term “competence”. The case is one regarding Saints owner Tom Benson who is fighting a mental competence case. An Orleans Parish judge has ruled that his medical records will be kept secret. Following this ruling, the evaluations and other relevant records that are used to review 87-year-old Benson’s mental capabilities will be seen only by the judge, lawyers and doctors. As in any court case involving medical evaluation, the review process will provide key information that would have an impact on the decision whether Benson retains control of his fortune. Benson’s family holds that his mental faculties and memory have been in heavy decline following his knee surgeries, and his decision to leave the Saints and the NBA’s Pelicans to his third wife Gayle Benson is born out of his incompetence. However, Benson’s lawyers maintain that his faculties are still sharp and that he is very actively involved in his business. According to them, the millionaire decided to cut out his heirs finding that they are not worthy to take over his assets in spite of having spent many years grooming them to be his worthy successors.

The Legal Competence Issue

How is a person’s legal competence important? This is important with regard to medical treatment choices, decision making in everyday as well as extraordinary factual contexts, personal decisions including financial deals, and who to live with or where to live, executing a will and so on. Attorneys handling legal competence cases request the medical records of the “incompetent” person for review purposes. These healthcare records contain evidence regarding the treating physician’s observations, clinical diagnoses and treatments provided to the patient. A comprehensive evaluation of the patient’s records will throw light on medical conditions that could have an impact on a patient’s mental competence, such as psychoses and depression, dementia and delirium – often called the “three Ds”. Very often, the treating doctor’s expert opinion may also be sought apart from the healthcare details.These evidences are used by attorneys to prove the competence or incompetence of a person in court.

Insanity Defense – the Need to Tread Carefully

Now, leaving Benson’s case aside, let us consider the complex question of mental health and the law. There are certain legal standards that apply when mentally ill persons are forced, unwillingly to undergo treatment. The due process clause of the 14th amendment controls the statutes for involuntary commitment whether named civil or criminal. This is to keep in check involuntary commitment that severely infringes on a person’s right not to be confined unnecessarily and the right to remain free from governmental restraint. When it comes to insanity defense, states have laws regarding how and when it may be invoked in state court, whereas for the federal court system the federal government rules apply.

The law can have a serious impact on the lives of the mentally ill and those with mental health problems. It may affect everything from employment opportunities, access to healthcare services and accommodation to their experience within the court system. It can compromise their chance of recovery and overall wellbeing. Therefore, courts hold that the criminal justice system has, of necessity, to address issues of responsibility, appropriateness of trial and treatment in the light of mental health considerations.

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