Challenges in Capacity & Decision Making

The common law provides each individual with legal rights to determine his or her own health-care (The National Conference of Commissioners on Uniform State Laws [NCC], 2014). In addition, an individual have the right to refuse treatment that would sustain life (NCC, 2014). The Model Health-Care Consent Act addressed the issue of consent to treatment, but does not address the problems of a patient who is dying (NCC, 2014). When a person lacks legal capacity, the issue is unclear and can be complex. The law in many states does not provide clear answers to the question of who may make health-care decisions for adults who lack legal capacity and have no designated guardian (NCC, 2014).
In this scenario, the relevant legal issue at stake is rather Mr. Jones makes his health care decisions or his daughter. Legally, the patient has the right to make his own health care decision if he has the capacity to do so (NCC, 2014). However, it is stated that Mr. Jones has been diagnosed with Alzheimer’s disease and a preliminary capacity assessment shows results consistent with mild dementia. Thus, it is unclear if Mr. Jones has the capacity to make his own health care decisions. Furthermore, Mr. Jones does not have an advance directive of any kind and is not under guardianship. An advance directives is a form of a “living will” or “durable power of attorney” which allow the patient to state in advance the kinds of medical care that s/he considers acceptable or not acceptable (Pozgar, 2014, p. 139). Therefore, the question is whether his daughter can make health-care decisions for her father.
As Pozgar (2014) states, “it is necessary to consider first what rights a competent patients possesses” (p. 126). It is important that Mr. Jones possesses decisional capacity and can provide informed consent (Duffy, 2010). The physician and health care providers must determine if Mr. Jones can comprehend, appreciate, and reason the contingencies of treatment or non-treatment.