Assessing testamentary capacity in the terminal phase of an illness or at a person's deathbed is fraught with challenges for both doctors and lawyers. Numerous issues need to be considered when assessing capacity for a will. These issues are exacerbated when such an assessment needs to be undertaken at the bedside of a dying patient. The nature and severity of the illness, effects on cognition of the terminal illness, effects of medication, urgency, psychological and emotional factors, interactions with carers, family and lawyers, and a range of other issues confound and complicate the assessment of capacity. What is the doctor's role in properly assessing capacity in this context and how does this role intersect with the legal issues? Doctors will play an increasing role in assessing testamentary capacity in this setting. The ageing of society, more effective treatment of acute illness and, often, the prolongation of dying are only some of the factors leading to this increasing need. However, despite its importance and increasing prevalence, the literature addressing this challenging practical area is scarce and offers limited guidance. This paper examines these challenges and discusses some practical approaches.
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http://dx.doi.org/10.1093/ageing/afw055 | DOI Listing |
Am J Geriatr Psychiatry
November 2024
Sunnybrook Health Sciences Centre (K.S.), University of Toronto, Toronto, Ontario. Electronic address:
An increase in will challenges on the grounds of lack of capacity and undue influence is anticipated in the face of an imminent transfer of generational wealth by a growing elderly population with a high prevalence of cognitive impairment. Medical experts will be a necessary element of litigation to help the courts make the best legal determinations involving cognitive and psychiatric functions that may affect mental capacity and vulnerability to influence. We conducted the first systematic literature review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses ("PRISMA") guidelines in order to identify articles that addressed a comprehensive medico-legal approach to the assessment of testamentary capacity.
View Article and Find Full Text PDFAm J Geriatr Psychiatry
September 2024
Division of Geriatric Psychiatry, Department of Psychiatry (C.C., K.S.), Sunnyrbook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Objectives: The objective of this continuing medical education course was to improve the knowledge and skills of physicians in the assessment of testamentary and related capacities.
Methods: We developed, conducted, and evaluated an accredited medical education course focusing on the role and responsibilities of medical experts in estate litigation and held in Toronto, Ontario, Canada in June 2022.
Results: Participants reported a 65% and 35% improvement in confidence in conducting retrospective and contemporaneous assessments of testamentary capacity, respectively.
Front Psychol
June 2024
Department of Neurology, The University of Iowa, Iowa City, IA, United States.
Appl Neuropsychol Adult
March 2024
Department of Child and Adolescent, Democritus University of Thrace, Alexandroupolis, Greece.
Succession law, which governs the creation and validity of wills, is closely tied to testamentary capacity (TC), the cognitive competence required for a valid will. This study explores TC in acute stroke patients and its connections to demographic and clinical characteristics. The research included first-time stroke patients admitted within 24 hours of symptom onset, meeting specific criteria.
View Article and Find Full Text PDFInt J Law Psychiatry
August 2024
Mental Health and Specialist Services, Gold Coast Health, Gold Coast, QLD, Australia; School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia; Mental Health Policy Unit, Health Research Institute, University of Canberra, Canberra, ACT, Australia.
Objective: To systematically review the literature on methods for the standardized and objective assessment of Testamentary Capacity (TC), to identify the best evidence-based and clinically pragmatic method to assess TC. Doubts concerning TC can have far-reaching legal and financial implications.
Method: A systematic search of the literature was conducted, using PRISMA guidelines, to identify studies which describe methods or tools for the assessment of TC.
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