title: Capable of more: some underemphasized aspects of capacity assessment.
abstract: BACKGROUND
  The 4-abilities model of decision-making capacity is vulnerable to constricted application and teaching.
  
  
  OBJECTIVE
  The authors attempt to assert the fundamentally clinical nature of capacity evaluations, while acknowledging that the concept of decision-making capacity must be legally grounded.
  
  
  METHODS
  Relevant aspects of clinical care are examined and emphasized as they apply to the evaluation of capacity for medical decision making.
  
  
  RESULTS
  Accessing patients' maximal abilities, attending to noncognitive aspects of choice, and identifying diagnostic explanations for patients' difficulties are important components of these assessments.
  
  
  CONCLUSIONS
  The evaluation of medical decision-making capacity is not a purely forensic task; it is enhanced by an approach that bridges the clinical-forensic divide.
authors: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA.. Electronic address: nkontos@partners.org.
authors: Nicholas
authors: N
authors: Kontos
authors: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors: John
authors: J
authors: Querques
authors: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors: Oliver
authors: O
authors: Freudenreich
mesh_terms: D003657:Decision Making; D005555:Forensic Psychiatry; D006801:Humans; D016743:Mental Competency / Q000331:legislation & jurisprudence / Q000523:psychology*