When the Mind Fails: A Guide to Dealing with Incompetency

Incompetency is loss of the ability to make, and act on, your own decisions and with the aging of North America's population, it is increasingly widespread. It can happen to anyone and many people want to plan for its possibility in order to ensure their own care and protection. Incompetency can cause great, but often avoidable, suffering and emotional anguish to those afflicted by it, as well as the relatives and friends who care for them. People in health care, financial services, and law must deal with clients whose competency in some, or all, matters can be questioned. Addressing the needs of incompetent people, or planning for its possibility, requires knowledge about what incompetency is, how to recognize and react to it, and what kinds of professional advice to seek. This book is a practical, focused guide to thinking about incompetency, as useful to the layman as to those who perform, or refer clients to, competency assessments.

Addressing the needs of incompetent people, or planning for its possibility, requires knowledge about what incompetency is, how to recognize and react to it, and what kinds of professional advice to seek. This book is a practical, focused guide to thinking about incompetency, as useful to the layman as to those who perform, or refer clients to, competency assessments.

Michel Silberfeld, a doctor, and Arthur Fish, a lawyer, draw on their experience at a competency clinic, citing fictional but realistic case studies and offering many concrete examples. The clinic is multidisciplinary and founded on the principle that competency is not simply a medical or legal concept, but rather a complex phenomenon that has medical, social, legal, and ethical dimensions. Silberfeld and Fish follow the same principle in the advice they offer.

There are fundamental problems associated with incompetency and many similarities among the laws and social policies that apply to incompetent people in North America. This book is not a substitute for qualified professional help but it is a practical guide to thinking about incompetency, based on the premise that the best source of personal empowerment is knowledge and understanding.

Arthur Fish is a lawyer whose practice is restricted to health-care issues, and a doctoral candidate in the Faculty of Law, University of Toronto. He was formerly a Legal Fellow with the Competency Clinic, Baycrest Hospital, Toronto.

Michel Silberfeld is a member of the Department of Psychiatry and a founding member of the Department of Bioethics, University of Toronto. He is a medical doctor and Coordinator of the Competency Clinic, Baycrest Hospital, Toronto.