Which statement best defines competence in medical decision-making?

• A. The obligation to involve a surrogate in all decisions
• B. The patient must be able to pay
• C. The ability to render decisions about medical interventions
• D. The need for patient to be physically healthy

Answer: (C)

Decision-making capacity in medicine is about whether a patient can understand information about options, appreciate the consequences, reason about benefits and risks, and communicate a choice. The statement that best defines competence is the ability to render decisions about medical interventions, because it directly captures the essential function: making a treatment choice that reflects understanding and personal preferences. Surrogate involvement is used when capacity is not present, so it describes a process that follows competence, not the definition. The ability to pay and physical health status do not determine competence; people with serious illness or financial constraints can still have the capacity to decide, and capacity is not about health status alone.