Assessment of Medical Decision-making Capacity in Patients With Dementia. Issue 3 (June 2018)

• Record Type: Journal Article
• Authors: Rodgers, Joshua J.; Kass, Joseph S.
• Is Part Of: Continuum. Volume 24:Issue 3(2018)
• Publication Date: 2018-06
• Subjects: Neurology -- Periodicals; Neurology -- Study guides -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1212/CON.0000000000000600
• Languages: English
• ISSNs: 1080-2371

Abstract

Abstract : ABSTRACT: Medical decision-making capacity, the patient's ability to exercise autonomy reasonably, is an essential component of both informed consent and informed refusal. The assessment of medical decision-making capacity is thus fundamental to the ethical practice of medicine. Medical decision-making capacity is not all or nothing but rather exists on a continuum and should be assessed on a decision-by-decision basis. Alzheimer disease and other neurocognitive disorders can affect a patient's medical decision-making capacity and may pose special challenges to capacity assessment. To illustrate some of these challenges, this article presents a case of a patient with Alzheimer disease who refused a recommended operation and discusses the components of capacity, a useful mnemonic and tools, the variability of state laws, and the roles neurologists and psychiatrists play in the assessment of capacity.