Who is typically authorized to perform capacity assessments?

• A. Medical assistants
• B. Administrative staff
• C. Clinicians such as physicians, psychiatrists, or psychologists
• D. Family members

Answer: (C)

Capacity assessments hinge on whether the person can understand information, appreciate consequences, reason about options, and communicate a choice about a specific medical decision. This requires clinical judgment and is typically performed by a licensed clinician trained in medical decision-making—most often a physician, psychiatrist, or psychologist. They review medical and cognitive history, assess understanding and reasoning, and determine if the person can give informed consent or if a substitute decision-maker is needed, with documentation for legal use. Non-clinical staff such as medical assistants or administrative personnel don’t have the training or authority to render capacity judgments, though they can collect information or support the process. Family members may provide important context, but capacity determinations should come from a qualified clinician to avoid bias and protect the patient’s rights. Remember, capacity is decision- and time-specific; a person may have capacity for some decisions and not others, or capacity can change with health status.