Diseases & Conditions >

Capacity (Competence) Determination and Informed Consent

Jon S Parham, DO, MPH, FAAFP and Sandra N New, DNP Reviewed 06/2022

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 42% of the cases (1)[C]

HISTORY

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

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 in rank order, have responsibility for medical decision making /informed consent if patient lacks capacity:

Spouse (unless legally separated)
Adult child
A parent
An adult sibl...

REFERENCES

1

Barstow C, Shahan B, Roberts M. Evaluating Medical Decision-Making Capacity in Practice. Am Fam Physician. 2018 Jul 1;98(1):40-46.

2

Yadav KN, Gabler NB, Cooney E, et al. Approximately one i...

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 pat...

CODES

SNOMED

203031000000107 Informed consent given
768021000000109 Finding of capacity to give consent
32082000 Competence

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 and a c...

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