Method for assessment of competency to consent in the mentally ill. Rationale, development, and comparison with the medically ill.

The doctrine of informed consent has been widely accepted and the patient’s right to self-determination highly respected, particularly in Western countries. In Japan, the doctrine of informed consent was introduced quite recently. The necessity of doctor’s disclosure of medical information has been discussed since the 1970s. The term “medical ethics” was introduced in the 1980s and the concept of informed consent was increasingly respected in Japan. In 1988 the Ministry of Health issued an interim report relating to the future medical practice in Japan. It said that in view of the introduction of the concept of informed consent, it is desirable to take into account that patients receive satisfactory medical information—purpose, expected effects, and alternative of the