Who Has the Ability to Consent?

Area of Science:

• Medical Ethics
• Clinical Psychology
• Emergency Medicine

Background:

• Inconsistent methods exist for assessing patient consent capacity in hospital emergency departments (EDs).
• Previous research has not consistently examined patient consent abilities in ED settings.

Purpose of the Study:

• To compare provider opinions with three capacity assessment tools for medical and psychiatric patients in the ED.
• To determine the most effective tools for assessing patient consent ability in emergency settings.

Main Methods:

• A study involving 283 English-speaking patients aged 18+ in a level 1 inner-city ED.
• Administered three tools: standard ED consent form, Aid to Capacity Evaluation (ACE), and Mini-Mental State Examination.
• Compared assessment results with provider's opinion on patient consent ability.

Main Results:

• 84.4% of patients were deemed able to consent by providers.
• High consistency observed between provider assessments and the three capacity tools.
• Most medical and psychiatric patients could consent, except for 32.6% of psychiatric patients with schizophrenia.

Conclusions:

• The Aid to Capacity Evaluation (ACE) demonstrated high consistency with provider assessments for medical (88.3%) and psychiatric (80.3%) patients.
• ACE tool identified significant difficulties for psychiatric patients with schizophrenia in understanding illnesses and treatments, impacting consent ability.
• Capacity assessment tools are crucial for ensuring informed consent, especially for vulnerable patient populations in the ED.