11/13 Legal Decision Making

Question 1

what is the difference between legal competence and decision making capacity

Answer 1

capacity is about what someone’s abilities are (medical), competence is decided by the courts concerning legal powers that a person might have (legal) and is all or nothing.

Question 2

what is important in determining decisionmaking capcity

Answer 2

what do they understand about the condition, what is at stake, and what the choices might be…the more they understand, the more capacity they have. Talk with them and don’t ask yes/no! what is there conditioin, what do they care about and can they link what they care about to what is going on with the condition.

Question 3

how to select surrogates?

Answer 3

Did they pick a surrogate already? is the patient under gaurdianship? What is the priority list of default surrogates in your jurisdiction (spouse, other adult family members..child, parent, sibling, grandchild, grandparent. other adult with special care and concern who knows the personal values)? Are any of these available and willing to serve as surrogate? can they be readily contacted?

Question 4

how do surrogates function in making decisions on behalf of patients who lack decision-making capacity

Answer 4

to act with the patient’s expressed wishes or substituted judgment, or at least make decisions i the patient’s best interest.