title: Assessing decision-making capacity: a primer for the development of hospital practice guidelines.
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.
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Second Floor, Philadelphia, PA, 19104, USA, andrew.siegel@uphs.upenn.edu.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Siegel
authors.forename: Anna S
authors.initials: AS
authors.lastname: Barnwell
authors.forename: Dominic A
authors.initials: DA
authors.lastname: Sisti
mesh_terms: D032921:Consensus; D028741:Ethics Committees, Clinical; D006739:Hospital Administration; D006801:Humans; D007258:Informed Consent / Q000941:ethics*; D016743:Mental Competency; D017410:Practice Guidelines as Topic; D024382:Professional Role