Decision-making capacity: from testing to evaluation

A guide to assessing decision-making capacity.

Many patients have uncertain capacity to make decisions about their care. Determining whether a patient possesses decision-making capacity challenges even the most seasoned of physicians. We illustrate an algorithm devised by Miller and Marin (Emerg Med Clin North Am 2000; 18:233-241) that assesses the patient's understanding of his or her condition, ability to process information, and stabilit...

An Evaluation of the Decision-Making Capacity Assessment Model

BACKGROUND The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted. METHODS A mixed methods approach was used. Survey (N = 126) and focus group (N = 49...

From shared decision making to patient-centered decision making

Shared decision making involving patients and physicians has gained adherents in Israel and other countries and has many virtues. This commentary argues that medical decision making should ideally be shaped by the particular needs and preferences of the patient, which may be to share in decision making, or at times call for a physician to assume full responsibility for decisions or, at the othe...

From Medical Decision-making to Medical-cost-comparative Decision-making.

WHEN A PHYSICIAN GATHERS A PATIENT’S history, runs diagnostic tests and performs an evaluation, he or she is performing medicine’s most fundamental act: medical decision-making. Patient care is all about physicians bringing their education, training and personal experience to bear with a particular patient and his or her particular symptoms, disease or injury. Frequently, the course of treatmen...

An AHP-Delphi Multi-Criteria Decision Making Model with Application to Environmental Decision-Making