Who determines a patient's competency and capacity?

Who determines a patient's competency and capacity?

• A. Competency—the court; Capacity—any physician (does not require a psychiatrist)
• B. Competency—the court; Capacity—the court
• C. Competency—any physician; Capacity—the court
• D. Competency—the patient; Capacity—the nurse

Answer: (A)

Competency and capacity are two different kinds of determinations. Competency is a legal status decided by a court, outlining a person’s overall ability to manage their affairs and make major decisions. Capacity is a clinical judgment about a specific decision at a specific time, and it’s assessed by a healthcare professional, typically a physician (often with expertise in mental health). The best choice reflects that distinction: the court determines competency, while a physician determines capacity. Capacity assessments focus on whether the patient can understand, appreciate, reason about, and communicate a choice about a particular medical decision, and these assessments can be made by a physician without requiring a psychiatrist. It’s also important to remember that capacity is decision-specific and can vary over time. So, the idea is that legal competence is decided by the court, whereas medical capacity for a given decision is determined by a clinician.

Competency and capacity are two different kinds of determinations. Competency is a legal status decided by a court, outlining a person’s overall ability to manage their affairs and make major decisions. Capacity is a clinical judgment about a specific decision at a specific time, and it’s assessed by a healthcare professional, typically a physician (often with expertise in mental health).

The best choice reflects that distinction: the court determines competency, while a physician determines capacity. Capacity assessments focus on whether the patient can understand, appreciate, reason about, and communicate a choice about a particular medical decision, and these assessments can be made by a physician without requiring a psychiatrist. It’s also important to remember that capacity is decision-specific and can vary over time.

So, the idea is that legal competence is decided by the court, whereas medical capacity for a given decision is determined by a clinician.