Decision-making capacity is defined as which of the following?

• A. The patient's expressed wishes
• B. The physician's assessment of best interest
• C. The patient's psychological or legal ability to make adequate decisions
• D. The patient's financial status

Answer: (C)

Decision-making capacity is the patient’s current mental ability to understand information about a medical choice, appreciate its consequences, reason about the options, and communicate a clear decision. It’s specific to the decision at hand and can change over time or with circumstances. This is why the best answer describes the patient’s psychological (mental) ability to make adequate decisions.

Explaining the other ideas helps reinforce the concept: capacity isn’t just about what the patient wishes or expresses, though those wishes are important for autonomy; it’s about whether the patient can actually grasp and weigh information to make a choice. It isn’t the physician’s assessment of what’s best for the patient—that’s about determining the appropriate course of action (and may involve surrogate decisions if capacity is lacking). And financial status has no bearing on the patient’s ability to understand or decide.