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However, a more formal capacity evaluation should be considered if there is reason to question a. Use of a standard cognitive assessment instrument is c helpful in assessing for capacity when patients score at the extremes of the scale (very high score favors capacity and very low score favors incapacity). Capacity is a clinical assessment that can be supported by standardized measures Determining capacity requires a careful and individualized assessment of a patient’s understanding of relevant information, communication of a choice, appreciation of the situation, and reasoning abilities.
The purpose of the aid to capacity evaluation (ace) is to help clinicians systematically evaluate capacity when a patient is facing a medical decision. Paul appelbaum outlines four criteria that patients must meet to be deemed to have capacity [1, 2, 3] These four criteria are 1) communicating a choice, 2) understanding the relevant information, 3) appreciating the situation and its consequences, and 4) reasoning about treatment options.
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