Informed consent, which statement accurately describes capacity?

Informed consent, which statement accurately describes capacity?

• A. Capacity requires the patient to sign a form.
• B. Capacity can be assumed for all adults.
• C. Capacity requires understanding, appreciation, reasoning, and ability to communicate a choice.
• D. Capacity is determined solely by the absence of mental illness.

Answer: (C)

The key idea is that capacity for informed consent is about what a person can do regarding a specific medical decision, not a blanket trait. It rests on four abilities applied to the decision at hand: understanding, appreciation, reasoning, and the ability to communicate a choice. Understanding means the patient can grasp the essential information about the diagnosis, the proposed treatment, alternatives, and the potential risks and benefits. Appreciation goes deeper: the person recognizes how this information applies to their own situation and what it would mean for them personally. Reasoning involves weighing options, comparing risks and benefits, and considering consequences in light of their values. Finally, the patient must be able to articulate a clear and consistent choice. Capacity is time- and decision-specific; it can wax and wane and may differ from one decision to another. It is not shown simply by signing a form, and it is not automatically present or absent based on whether someone has a mental illness. In fact, many people with mental health conditions can have intact capacity for certain decisions, while others without mental illness may lack capacity for complex options due to cognitive issues, intoxication, or other factors.

The key idea is that capacity for informed consent is about what a person can do regarding a specific medical decision, not a blanket trait. It rests on four abilities applied to the decision at hand: understanding, appreciation, reasoning, and the ability to communicate a choice.

Understanding means the patient can grasp the essential information about the diagnosis, the proposed treatment, alternatives, and the potential risks and benefits. Appreciation goes deeper: the person recognizes how this information applies to their own situation and what it would mean for them personally. Reasoning involves weighing options, comparing risks and benefits, and considering consequences in light of their values. Finally, the patient must be able to articulate a clear and consistent choice.

Capacity is time- and decision-specific; it can wax and wane and may differ from one decision to another. It is not shown simply by signing a form, and it is not automatically present or absent based on whether someone has a mental illness. In fact, many people with mental health conditions can have intact capacity for certain decisions, while others without mental illness may lack capacity for complex options due to cognitive issues, intoxication, or other factors.