Checklist for Capacity to Make Treatment Decisions
Part 1: Factual Understanding of Issues
<-- What is wrong with you (or what illness do you have)?
<-- What are the treatment or tests recommended for you?
<-- What are the treatments supposed to do for you?
<-- What might happen with the treatment that you do not want to happen?
<-- What else could be done for your illness/problem (pros/cons)?
<-- You mentioned that your doctor told you about risks with treatment – how likely do you think it is that the risks might occur?
<-- Why is your doctor giving you all this information?
Part 2: Appreciation of Consequences
<-- Explain what you believe is wrong with your health.
<-- Do you believe you need treatment? What is treatment likely to do for you?
<-- What do you believe will happen if you are not treated?
<-- Why do you think your doctor has recommended specific treatment for you?
Part 3: Rational Manipulation of Information
<-- Tell me how you reached the decision to accept or reject the recommended treatment?
<-- What were the things that were important in reaching your decision?
<-- How did you balance the pluses and minuses?
Comments/Discussion
display/hide references

Result - Copy and paste this output: