Professional Practice: The Daily PANCE Blueprint
A 68-year-old male refuses emergent surgery after hearing the risks—who determines whether he has decision-making capacity?
A. Treating clinician
B. Hospital ethics
C. Court judge
D. Family surrogate
E. Psychiatry only
Answer and topic summary
The answer is A. Treating clinician
Capacity is a clinical call by the treating clinician. It’s task- and time-specific and requires the patient to understand, appreciate, reason, and communicate a choice. If capacity is absent and delay risks harm, implied consent permits emergent treatment.
Incorrect Answer Explanations:
- Hospital ethics — Consultative; does not determine capacity.
- Court judge — Rules on competence (legal), not clinical capacity.
- Family surrogate — Decides only if capacity is absent; doesn’t assess it.
- Psychiatry only — Can assist, but any clinician may assess capacity.
