The authors employed a structured interview to ascertain public defenders' perceptions of their clients' competence and the degree of their participation in the defense. In a sample of 122 randomly selected, non‐dismissed felony cases, attorneys had doubts about the competence of 14.8% (n = 18) of their clients. Attorneys reported that clients whose competence was doubted were less involved in decision‐making and, overall, were passive participants in their cases. Nearly one‐half of these clients were not referred for assessment by a mental health professional. The authors compare the practices of attorneys faced with clients of suspected competence with those of mental health clinicians treating patients with impairments in decision‐making capacity.

Richard J. Bonnie et al., Attorney-Client Decision-Making in Criminal Cases: Client Competence and Participation as Perceived by Their Attorneys, 10 Behavioral Sciences & the Law, 385–394 (1992).