Monday, August 8, 2011
For most patients, mental capacity to make medical decisions either clearly exists or is clearly absent. But for a number of patients, including those with developing Alzheimer disease, it may not be obvious whether mental capacity is present.
How accurate are physicians at detecting a patient's incapacity? A recent review-of-the-literature study found that physicians “missed the diagnosis in 58% of patients who were judged incapable” in a formal, independent assessment. On the other hand, physicians generally were correct when they made a diagnosis of incapacity. The researchers also found that the best formal assessment tool for measuring capacity is the Aid to Capacity Evaluation. Laura L. Sessums, Does This Patient Have Medical Decision-Making Capacity?, 306 JAMA 420 (2011).