Abstract
Decision making capacity (DMC) is a fundamental concept grounding the principle of respect for autonomy and the practice of obtaining informed consent. DMC must be determined and documented every time a patient undergoes a hospital procedure and for routine care when there is reason to believe decision making ability is compromised. In this paper we explore a path toward ethically informed development and implementation of a hospital policy related to DMC assessment. We begin with a review of the context of DMC assessment before discussing some considerations relevant to policy creation by healthcare ethics committees. The discussion concludes in a presentation of a typology of capacity assessment policies, which draws upon a sampling of currently used hospital policies to illustrate relevant ethical considerations.
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Acknowledgments
The authors acknowledge and thank Paul Appelbaum for initial feedback, the Thomas Scattergood Behavioral Health Foundation for providing support, and Katherine Buckley for her editorial assistance.
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Siegel, A.M., Barnwell, A.S. & Sisti, D.A. Assessing Decision-Making Capacity: A Primer for the Development of Hospital Practice Guidelines. HEC Forum 26, 159–168 (2014). https://doi.org/10.1007/s10730-014-9234-8
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DOI: https://doi.org/10.1007/s10730-014-9234-8