Medical Decision Making

Author: Nasiya Ahmed, MD, Susan Gorman, MSN, RN, GNP, & Rechelle Asirot, MD


Medical law and ethics presume an adult can make medical decisions about their care.

The burden is placed on the responsible physician to determine whether a patient lacks that ability. This joint process involves the patient and physician, and may include advocacy and communication from others.

Executive function is a cognitive ability that involves the planning and execution of goal-directed behaviors, abstract reasoning, and judgment.

Executive function involves decisional capacity beyond medical decision making. The patient must be able to successfully practice self-care and self-protective functions such as activities of daily living (ADL's) and independent activities of daily living (IADL's). ADL's include bathing, grooming, toileting, and eating. IADL's include taking medications appropriately, food preparation, making and keeping medical appointments, fulfilling financial responsibilities and bill paying.


Key Points



To establish competence, the patient must:

Try using this easy mnemonic, U R Definitely Capable to remember.

Assessment Tools available for your use in the clinical setting:



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