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Does This Patient Have Medical Decision-Making Capacity?

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Does This Patient Have Medical Decision-Making Capacity?

Post  Admin on Thu Nov 24, 2011 6:10 pm

Does This Patient Have Medical Decision-Making Capacity?

One of your patients, a 72-year-old woman, comes to you for a preoperative evaluation for a total hip replacement. Her medical history includes early-stage Alzheimer disease. At a recent clinic visit, her husband noted his wife seemed more forgetful, and on examination, her Mini-Mental State Examination (MMSE) score was 21 out of 30 points. Today, you ask the patient what she understands about the risks and benefits of the planned procedure. She smiles and tells you it will fix her hip. When you give her information about risks and alternative treatment options, and query about her understanding, she continues to smile and replies, “It’ll be okay.” You wonder whether she has the capacity to make the decision to proceed with the operation.

Read this interesting article published in JAMA (July 2011):
http://jama.ama-assn.org/content/306/4/420.full.pdf+html

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