ABSTRACT
The capacity to make medical treatment decisions (hereafter consent capacity or competency) is a fundamental aspect of personal autonomy. Consent capacity refers to a patient’s cognitive and emotional capacity to accept a proposed treatment, to refuse treatment, or to select among treatment alternatives (Grisso, 1986; Tepper & Elwork, 1984). Consent capacity is the cornerstone of the medical-legal doctrine of informed consent, which requires that a valid consent to treatment be informed, voluntary, and competent (Kapp, 1992; Marson, Ingram, Cody, & Harrell, 1995; Marson, Schmitt, Ingram, & Harrell, 1994). From a functional standpoint, consent capacity may be viewed as an “advanced activity of daily life” (ADL; Wolinsky & Johnson, 1991) and an important aspect of functional health and independent living skills in older adults (see Park, 1992; Willis, 1996).
