Hostname: page-component-7c8c6479df-fqc5m Total loading time: 0 Render date: 2024-03-27T16:08:34.817Z Has data issue: false hasContentIssue false

Instruments to assess decision-making capacity: an overview

Published online by Cambridge University Press:  21 December 2004

Astrid Vellinga
Affiliation:
Center for Ethics and Philosophy of Life and Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
Johannes H. Smit
Affiliation:
Center for Ethics and Philosophy of Life and Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
Evert van Leeuwen
Affiliation:
Center for Ethics and Philosophy of Life and Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
Willem van Tilburg
Affiliation:
Center for Ethics and Philosophy of Life and Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
Cees Jonker
Affiliation:
Center for Ethics and Philosophy of Life and Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands

Abstract

Objective: The main objective of this article is to evaluate and describe instruments for assessing decision-making capacity in psychiatry and psychogeriatrics, and to evaluate them for use in daily practice.

Methods: The instruments were selected in Medline articles. We focus on the relationship between these instruments and the concept of competence, represented in the following elements: context in which an instrument is developed, disclosure of information, standards to assess decision-making capacity, the scale or threshold model, and validity and reliability.

Results: The developmental context influences how information is provided and standards defined. Although it is not clear how decision-making capacity relates to competency judgments, most instruments provide good reliability.

Conclusions: Comparison of the different instruments opens directions for future research. Although instruments can never replace a physician's judgment, they may provide a clear starting point for a discussion on competence. In daily practice assessments, attention should be given to information disclosure, the influence of our own normative values in evaluating standards of decision-making capacity, and the relation between decision-making capacity and competence.

Type
Review Article
Copyright
© International Psychogeriatric Association 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)