Capacity Assessment and Scope of Practice Laws: A Call for Modest Reform

State laws governing decisional capacity assessment in the clinical setting vary considerably, but many jurisdictions limit evaluations exclusively to physicians. At the same time, the states have generally expanded the scope of practice of nonphysician healthcare professions in many other areas. This article examines the current statutory frameworks, critiques reliance on physician exclusivity, and advances arguments for modest reform. Empowering advanced practice nurses, physician assistants, psychologists, and social workers to perform capacity determinations would enhance therapeutic relationships, improve timeliness of care, and promote equitable resource stewardship without compromising patient safety or autonomy.