Elderly too easily can be stripped of civil liberties, assets
JAMES C. VAN DOREN
In providing psychiatric care to geriatric patients, there are serious and frequent lapses in ethical practice with regard to guardianships and capacity determinations in Pima County.
"I often am befuddled by the tenacity and utter lack of ethical objectivity demonstrated by attorneys and the mental health professionals who provide so-called "expert opinion" in many of these cases."
All too often the outcome is determined long before any clinical evaluation is performed - and not surprisingly favors the party employing the attorney.
It is truly frightening just how easy it is for many of our elderly citizens to be stripped of their civil liberties and placed in restrictive and coercive custodianships that seize and control their assets and limit their recourse to appeal.
"I have witnessed outright denial and direct contradictions between the facts of these cases and the brief and predictable summary statements that the person is determined to be demented and therefore "incompetent" in general."
The proverbial metaphor of a fox in the hen house does not quite capture the greed and dispassionate disregard for human suffering that ensues.
"It seems readily apparent to me that there is an inherit conflict of interest in being both attorney and public fiduciary in these instances. After all, what better way to siphon away the wealth of their "clients" than to charge attorney's fees for every service rendered to their involuntary "clients" while at the same time control any access they might have to counsel or appeal."
Unfortunately, the standard that is almost universally applied is limited to a single neuropsychological evaluation that is performed by a psychologist with no real-world knowledge of the patient. The psychologist is hired by the attorney as an "expert witness" and is thereby biased to provide the desired opinion - "not competent."
The unsuspecting senior is usually caught off guard and often traumatized by the experience. Many perfectly fit and sane individuals have been trapped by this design.
"I am deeply troubled by far too many experiences with less than ethical attorneys, fiduciaries and mental health professionals in this business - a lucrative business that has the potential to corrupt even the best of intentions."
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James C. Van Doren, M.D., is a board-certified psychiatrist in Tucson.