In Western biomedical ethics, the patient's right of autonomy (making one's own decisions) is highly honored. However, to exercise that right, the patient must demonstrate the capacity to make decisions. "Decision-making capacity" is defined as the patient's ability to make his or her own decisions about accepting or rejecting medical procedures or treatments. Decision-making capacity is decision-relative. That is, it is assessed in relationship to a specific decision, at a specific time, and in a specific context. A patient's capacity may wax and wane. A patient may have capacity even in the presence of a disease like dementia. Any qualified professional medical caregiver can assess decision-making capacity; it does not require a psychiatrist. It is not a legally rendered decision, such as a court determination of a person's mental competency.
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