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Evaluating Medical Decision-Making Capacity in Practice.

Craig Barstow¹, Brian Shahan¹, Melissa Roberts¹

¹Womack Army Medical Center, Fort Bragg, NC, USA.

American Family Physician

|September 15, 2018

Summary

This summary is machine-generated.

Patients must understand treatment options, risks, and benefits to have medical decision-making capacity, which is essential for informed consent. Formal evaluations are needed when capacity is questionable.

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Area of Science:

Medical Ethics
Clinical Practice

Background:

Medical decision-making capacity forms the foundation of informed consent in patient care.
Capacity ensures patients comprehend treatment implications, including alternatives and risks.

Purpose of the Study:

To define medical decision-making capacity.
To outline criteria for assessing patient capacity.
To guide physicians in evaluating and managing capacity.

Main Methods:

Capacity is assessed through patient's understanding, appreciation, reasoning, and communication.
Formal evaluation is indicated when decision-making abilities are questioned.
Physicians can utilize structured approaches and available assessment tools.

Main Results:

Capacity requires understanding of situation, appreciation of consequences, and reasoned communication.
Reasons for formal evaluation include altered mental status or unusual treatment choices.
Treating physicians make the final capacity determination, with psychiatric consultation available.

Conclusions:

Capacity assessment is crucial for ethical medical practice and informed consent.
A structured approach aids physicians in evaluating decision-making abilities.
Surrogate decision-makers are involved if capacity is lacking, with provisions for emergency care.