How do I determine if my patient has decision-making capacity?

How do I determine if my patient has decision-making capacity?

Capacity is the basis of informed consent. Patients have medical decision-making capacity if they can demonstrate understanding of the situation, appreciation of the consequences of their decision, and reasoning in their thought process, and if they can communicate their wishes.

Can doctors make decisions for patients?

When a patient lacks decision-making capacity, the physician has an ethical responsibility to: Identify an appropriate surrogate to make decisions on the patient’s behalf: The person the patient designated as surrogate through a durable power of attorney for health care or other mechanism.

Who determines if a patient is competent?

Competency is a global assessment and legal determination made by a judge in court. Capacity is a functional assessment and a clinical determination about a specific decision that can be made by any clinician familiar with a patient’s case.

What kind of decisions do doctors make?

The doctor uses specialist knowledge, experience and clinical judgement, together with any evidence about the patient’s views (including advance statements, decisions or directives), to identify which investigations or treatments are clinically appropriate and are likely to result in overall benefit for the patient.

When can a patient not refuse treatment?

Most of these patients cannot refuse medical treatment, even if it is a non-life-threatening illness or injury: Altered mental status: Patients may not have the right to refuse treatment if they have an altered mental status due to alcohol and drugs, brain injury, or psychiatric illness.

Who makes decisions for the mentally ill?

You can specify who you want to make these decisions for you in a legal document, called a health care power of attorney (POA). The person you specify is called a health care agent. (Sometimes people use the word “power of attorney” to describe the person as well as the document.)

How should a surrogate decision maker proceed on behalf of a patient?

Surrogate decision makers should base their decisions on the substituted judgment standard; in other words, they should use their knowledge of the patient’s preferences and values to determine as best as possible what the patient would have decided herself.