The Basics of Decision-Making Capacity: The Top-10 Principles for the Clinical Practice

Abstract

The Basics of Decision-Making Capacity: The Top-10 Principles for the Clinical Practice Abstract. Decision-making capacity (decisional competence) as the ability to act rationally is a prerequisite for self-determination and is presumed in adults. In case of justified doubts, a cursory exam and, if necessary, an in-depth evaluation should be carried out. In this article, the concept of decision-making capacity is presented for the clinical practice based on the ten most important legal, ethical, and clinical principles. The criteria for assessing decision-making capacity, the relativity of decision-making capacity in terms of time and subject matter, and a possibly fluctuating decision-making capacity are highlighted. It becomes clear that decision-making incapacity is an attribution based on ethical-normative considerations. It should be noted that the decision of a person with decision-making capacity doesn't necessarily have to be reasonable. Finally, the assessment tool U-Doc is presented to support evaluation.