I have recently started a hospital gig where I need to handle floor consults that arise on occasion. I haven't done consult psych in at least 4 years now (during residency). I get a lot of capacity eval requests and they are almost always - we want you to assess for medical decision making capacity. period.
My understanding was there had to be a specific question to assess capacity; a person could have capacity to refuse a medication but not have capacity for a medical procedure, for example. Therefore you can't broadly ask me or anyone to assess for global medical decision making capacity. Same would be true for DNR vs Full code, etc type decisions is my understanding. I often send these back and ask for more clarification before I assess the patient - am I being unnecessarily difficult?
In the event a patient is found to not have capacity for a medical decision that risks life or limb, how do we/primary team actually enforce this? What is the protocol once I determine they lack capacity?
Appreciate any advice to these ( very rudimentary) questions.
My understanding was there had to be a specific question to assess capacity; a person could have capacity to refuse a medication but not have capacity for a medical procedure, for example. Therefore you can't broadly ask me or anyone to assess for global medical decision making capacity. Same would be true for DNR vs Full code, etc type decisions is my understanding. I often send these back and ask for more clarification before I assess the patient - am I being unnecessarily difficult?
In the event a patient is found to not have capacity for a medical decision that risks life or limb, how do we/primary team actually enforce this? What is the protocol once I determine they lack capacity?
Appreciate any advice to these ( very rudimentary) questions.