Competency in informed consent

Assessing a patient's capacity to make competent decisions concerning her own care is an important clinical skill in healthcare, especially among those who are elderly, chronically ill, and institutionalized. Competency is an important presupposition to autonomous decision making. Assessing competency becomes increasingly critical when the patient's wish is to forego a life-saving procedure. Supporting a patient's choice regardless of the outcome of that decision is an important part of patient advocacy and therefore an important component of patient care. The essence of autonomy is described as it relates to defining meaningful informed consent. This article includes a model for assessing competence.