Skip to main content

Capacity (Competence) Determination and Informed Consent

Jon S. Parham, DO, MPH, FAAFP and Sandra N. New, DNP Reviewed 06/2020
 


BASICS

  • Personal autonomy in decision making is a fundamental personal freedom.

  • Capacity determination is an inherent element of the informed consent process.

  • It is universally presumed that patients 18 ...

DIAGNOSIS

In patients without capacity, physicians are unable or unwilling to recognize the incapacity in 42% of cases (4). 

HISTORY

Family or frequent observers are resources regarding behavior pattern...

TREATMENT

GENERAL MEASURES

Steps to take if a patient fails to have capacity or fails to display ability to participate in informed consent: 
  • Determine the acuity of the need for decision making (e.g., ...

ONGOING CARE

The following have responsibility for medical decision making and informed consent when the patient does not have capacity: 
  • Spouse (unless legally separated)

  • Adult child

  • A parent

  • An adult si...

REFERENCES

1
Barstow C, Shahan B, Roberts M. Evaluating medical decision-making capacity in practice. Am Fam Phys.  2018;98(1):40–46.
2
Yadav KN, Gabler NB, Cooney E, et al. Approximately one in thr...

ADDITIONAL READING

  • Baón-Pérez BS, Álvarez-Marrodán I, Navío-Acosta M, et al. Spanish validation of the MacArthur Competence Assessment Tool for clinical research interview for assessing patient’s ment...

CLINICAL PEARLS

  • Use a structured approach to assessing decision-making capacity, including an assessment of language barriers, identification and remediation of reversible causes of incapacity, a comp...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×