Assessing decision-making capacity

When patients refuse treatments or procedures against medical advice, a four-step interview process can help you assess their decision-making capacity.

Sabrina Ribeiro, MD PhD
Sabrina Ribeiro, MD PhD
6th Mar 2023 • 1m read
Assessing decision making capacity

Up to 31% of hospitalized patients and 70% of those nearing the end of life may have diminished decision-making capacity. Assessing the decision-making capacity of patients is crucial, particularly if their treatment preferences contradict medical advice or if they suffer from dementia, schizophrenia, or delirium. If a patient makes a decision that contradicts medical advice, it must not be assumed that they lack the capacity to make that decision. Each patient is different, and it is important to make sure they understand their diagnosis, how it affects them and their family, and the consequences of their decisions. This lesson will show you how to assess your patients using an interview process based on four steps: understand, communicate, appreciate, and reason.

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