Department of Public Health Sciences

A prospective observational study of decisional capacity determinations in an academic medical center

Kahn DR, Bourgeois JA, Klein SC, Iosif AM

The International Journal of Psychiatry in Medicine. 2009. 39(4):405-15.

OBJECTIVE: The main goals, of this observational study were to clarify and categorize decisional capacity assessments performed by a psychosomatic medicine (PSM) consult service at an academic medical center. Areas of investigation included types of decisional capacity requests, the relationship between Folstein Mini-Mental State Exam (MMSE) and PSM decisional capacity determination, psychiatric diagnoses of patients, and the agreement between primary clinician capacity assessment and that of the PSM clinician. METHOD: This was a prospective study of 100 consecutive decisional capacity consultations. Twelve requests were for second consultations for patients previously seen, for a net of 88 patients. RESULTS: In 77 cases, patients lacked decisional capacity. Assessments for capacity to leave against medical advice (AMA), capacity to accept medical/surgical procedures, capacity to refuse medical/surgical procedures, and capacity to participate in discharge planning were nearly equally frequent. An MMSE cutoff score of

Close Window

UC Davis Health System is pleased to provide this information for general reference purposes only. It should not be considered as a substitute for professional medical advice. You are urged to consult with your health care provider for diagnosis of and treatment for any health-related condition. The information provided herein may not and should not be used for diagnosis and treatment.

Reproduction of material on this web site is hereby granted solely for personal use. No other use of this material is authorized without prior written approval of UC Regents.