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Instruments to assess decision-making capacity: an overview.

Astrid Vellinga¹, Johannes H Smit, Evert van Leeuwen

¹Center for Ethics and Philosophy of Life, VU University Medical Center, Amsterdam, The Netherlands. astrid.vellinga@mentrum.nl

International Psychogeriatrics

|February 18, 2005

Summary

This study evaluates instruments for assessing decision-making capacity in psychiatry and psychogeriatrics. While most instruments show good reliability, physician judgment remains crucial for competence evaluations.

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Area of Science:

Psychiatry
Psychogeriatrics
Clinical Assessment

Background:

Assessing decision-making capacity is crucial in psychiatry and psychogeriatrics.
Existing instruments require evaluation for practical application and theoretical grounding.

Purpose of the Study:

To evaluate and describe instruments for assessing decision-making capacity.
To assess the suitability of these instruments for daily clinical practice.

Main Methods:

Systematic review of Medline articles.
Focus on the relationship between assessment instruments and the concept of competence, including context, information disclosure, standards, models, and psychometric properties.

Main Results:

The developmental context of instruments impacts information disclosure and standards.

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Most instruments demonstrate good reliability, though the link to competency judgments is not fully elucidated.

Conclusions:

Instruments can aid physician judgment by providing a structured starting point for competence discussions.
Future research should explore instrument comparison and refine understanding of decision-making capacity in relation to competence.