？Es el paciente crítico competente para tomar decisiones?: Razones psicológicas y psicopatológicas de la alteración cognitiva

background emotional factors may lead to cognitive impairment that can adversely affect the capacity of patients to reason, and thereby, limit their participation in decision taking. purposes: to analyze critical patient aptitude for decision taking, and to identify variables that may influence competence. design: an observational descriptive study was carried out. setting: intensive care unit. patients: participants were 29 critically ill patients. main variables: social, demographic and psychological variables were analyzed. functional capacities and psychological reactions during stay in the icu were assessed. results: the patients are of the firm opinion that they should have the last word in the taking of decisions; they prefer bad news to be given by the physician; and feel that the presence of a psychologist would make the process easier. failure on the part of the professional to answer their questions is perceived as the greatest stress factor. increased depression results in lesser cognitive capacity, and for patients with impaired cognitive capacity, participation in the decision taking process constitutes a burden. the variables anxiety and depression are significantly related to decision taking capacity.