How do you decide when to formally re-assess and document decisional capacity in a hospitalized patient who initially lacks it?

This is a great question and tricky to answer in every scenario. In general, we should be reassessing decisional capacity with each clinical encounter, though formal documentation may not be necessary each time. My approach is based on considering several factors:

1. What is the underlying cause of th...

Decisional capacity is always task-specific, so the first step is to identify the exact decision. Capacity for what? The threshold to accept a low-risk, high-benefit intervention like a CBC or a non-contrast CT is low, while the threshold to refuse that same intervention is higher. People are allowe...