What should be assessed to determine a patient's decision-making capacity?

• A. Orientation, gait and/or coordination, and speech pattern
• B. Age only
• C. Blood type
• D. Insurance status

Answer: (A)

Assessing decision-making capacity hinges on the patient’s current cognitive and communication abilities. A practical way to gauge this is to check orientation—whether they know who they are, where they are, and the current time—and to observe their gait/coordination and speech. If a patient is oriented, moves well, and speaks clearly, they’re more likely to understand information and express a reasoned choice, which supports capacity. If there’s disorientation, impaired coordination, or slurred or incoherent speech, it raises concern about cognitive or neurologic problems that could undermine understanding or the ability to communicate a choice. Age, blood type, or insurance status don’t reflect cognitive function or the ability to decide and therefore aren’t useful for this assessment.