Capable of more: some underemphasized aspects of capacity assessment

The 4-abilities model of decision-making capacity is vulnerable to constricted application and teaching.

The authors attempt to assert the fundamentally clinical nature of capacity evaluations, while acknowledging that the concept of decision-making capacity must be legally grounded.

Relevant aspects of clinical care are examined and emphasized as they apply to the evaluation of capacity for medical decision making.

Accessing patients' maximal abilities, attending to noncognitive aspects of choice, and identifying diagnostic explanations for patients' difficulties are important components of these assessments.

The evaluation of medical decision-making capacity is not a purely forensic task; it is enhanced by an approach that bridges the clinical-forensic divide.