Decision-making capacity

Older persons often have to deal with critical treatment decisions, frequently during periods when they are vulnerable and at risk of having impaired cognitive abilities. However, a diagnosis of dementia or other psychiatric illness does not necessarily indicate that the patient cannot make decisions. In this AAGP Psychiatry Rounds column, Dr. Lantz defines competency and capacity in the context of decision-making ability, discusses the role of the physician and the principle of assumed competence, and examines the four major components involved in the evaluation of decision-making capacity.