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Certification Q&A;
Assessing Patient Decision-Making
Capacity in Clinical Practice
Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC
AS A STUDENT, I learned that a patient must be considered capable of making
decisions in order for informed consent to be valid. How do I determine
whether a patient has the ability to make an informed decision in daily clini-
cal practice?
Respect for a patient's right to make autonomous choices regarding his or her
health care is a fundamental ethical principle underlying all healthcare interac-
tions between clinician and patient. Clinicians show respect for autonomy by ob-
taining informed consent, whereby the patient makes an autonomous decision to
undergo or forgo a procedure or treatment or
to take part in research. For informed consent
to be valid, the patient must have the ability to
make healthcare decisions, a concept known
as decision-making capacity.
1
Because the clini-
cian's assessment of decision-making capacity
has important ethical implications for a pa-
tient's self-determination—that is, what role
the patient will play in making choices about
his or her own health care—all clinicians
should have a good understanding of deci-
sion-making capacity and how to assess it.
What is capacity and how is it assessed?
Decision-making capacity is a functional assessment and a clinical determination
made by a clinician regarding whether a patient possesses the ability to make in-
formed decisions about his or her health care. It differs from competence, which is
a legal concept that can be formally determined only by a judge in court.
Inside
Certification Q& A ............. 1
Review Courses ................ 8
Allergy & Asthma
Consult ............................. 9
Avoiding Malpractice .... 17
News Briefs ..................... 21
2015 & 2016 Live Courses
Pharmacology Update
(2-day course)
The Art of Wound Repair
(1-day course)
NP Essentials
(4-day course)
NP Certification
Exam Review
Course Tracks
Family, Adult-Gerontology,
and Adult Primary Care
Adult-Gerontology
Acute Care
Psychiatric-Mental
Health
Women's Health
Pediatric Primary Care
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ommitted to the success of nurse practitioners
1
Fitzgerald Health Education Associates, Inc. 978•794•8366 Volume 15, Issue 8, August 2015
continued on page 3...