How is patient capacity assessed in the consent process?

• A. Assess willingness to follow the physician's recommendations.
• B. Assess only age and general health.
• C. Assess understanding, appreciation of consequences, and ability to communicate a choice.
• D. Assume capacity if the patient signs a consent form.

Answer: (C)

Understanding patient capacity in informed consent means checking whether the patient can understand the information about the option, appreciate how it applies to their own situation, reason about the choices, and communicate a clear decision. This is decision-specific and time-specific, not an overall judgment about a person’s intelligence or health. The elements—understanding the information, appreciating the consequences for oneself, and being able to express a choice—together determine whether the patient can consent.

Willingness to follow a physician’s recommendations isn’t the same as capacity; someone may understand and still choose differently, or may be influenced by factors that don’t negate capacity. Age or general health by themselves don’t determine capacity, since capable individuals exist across ages and health statuses. Signing a consent form doesn’t prove capacity, as a form can be signed without full understanding or under pressure.