Decision-making capacity in adults: its assessment in clinical practice

Abstract

In English Law, an adult has the right to make decisions affecting his or her own life, whether the reasons for that choice are rational, irrational, unknown or even non-existent. This right remains even if the outcome of the decision might be detrimental to the individual ( Re T (Adult: Refusal of Treatment) , 1992) or to a viable foetus ( Re S (Adult: Refusal of Medical Treatment) , 1992). However, such a right to self-determination is meaningful only if the individual is appropriately informed, has the ability (capacity) to make the decision and is free to decide without coercion (Grisso, 1986).