Medical Decision-making Capacity Assessment

Medical Decision-making Capacity Assessment - #60

Take Quiz

Determine an older adult’s ability to make medical decisions in a hospital or clinic setting.

Apply the four key abilities required for decision-making capacity to the patient interview and determine whether an elderly adult has capacity to make a given medical decision.

  1. Describe the differences between decision-making capacity and competency.
  2. Name the four abilities an individual must demonstrate to have decision-making capacity.
  3. Describe observable patient behaviors that demonstrate these abilities.
  4. Identify available tools to facilitate capacity assessment.
  5. Evaluate a patient for factors that may confound capacity assessment.
  6. Appreciate the fluid nature of capacity assessment and the need to re-evaluate over time 

1. Sessums LL, Zembrzuska H, Jackson JL.  Does this patient have medical decision-making capacity? Journal of the American Medical Association 2011; 306(4): 420-427.

2. Etchells E, Sharpe G, Elliot C, Singer PA.  Bioethics for clinicians: Capacity.  Canadian Medical Association Journal 1996; 155 (6): 657-661.

3. Appelbaum PS, Grisso T.  Assessing patients’ capacities to consent to treatment.  New England Journal of Medicine 1988 Dec 22; 319(25): 1635-1638.

4. Tunzi M.  Can the patient decide? Evaluating patient capacity in practice.  American Family Physician 2001; 64: 299-306.

5. Carling-Rowland, Alexandra. (2012). Communication aid to capacity evaluation (CACE). Available at: Accessed 5/11/2016.

6.  Okai D, Owen G, McGuire H, Singh S, Churchill R, Hotopf M.  Mental capacity in psychiatric patients: systematic review.  British Journal of Psychiatry 2007; 191: 291-297.

7.  Arozullah AM, Yarnold PR, Bennett CL, Soltysik RC, Wolf MS, Ferreira RM, Lee SD, Costello C, Shakir A, Denwood C, Bryant FB, Davis T.  Development and Validation of a Short-Form, Rapid Estimate of Adult Literacy in Medicine.  Medical Care 2007; 45: 1026-1033.

This GFF ___ my competence in geriatrics.

Elizabeth N. Chapman, MD

Clinical Assistant Professor of Medicine

University of Wisconsin School of Medicine and Public Health


Lisa L. Boyle, MD, MPH

Clinical Associate Professor of Psychiatry

University of Wisconsin School of Medicine and Public Health

University of Wisconsin School of Medicine and Public Health