Adults Who Can't Make Medical Decisions on Their Own | Éducaloi (2024)

Adultscanusuallymakemedicaldecisions(consent to treatment)on their own.Butthey may need someone to make medical decisions for themif their decision-making ability is affected by an illness or disability.This is called substituted consent.

Adults Who Can't Make Medical Decisions on Their Own | Éducaloi (1)

Deciding Whether SomeoneCanMakeMedicalDecisions

Whensuggestingtreatment, medical professionals mustevaluatewhethertheirpatientsare ableto make medical decisions. In law, this is called the capacity to consent.

Having a mental illness or disability doesn’t automatically mean a person can’t make their own medical decisions. Even a person under tutorship or for whom a protection mandate has been hom*ologated may be able to make certain medical decisions on their own. Also, refusing treatment that could be beneficial doesn’t necessarily mean someone can’t make medical decisions on their own.

When deciding whether a patient can make medical decisions, the doctor must evaluate whether the patient canunderstandthese things:

  • the natureofhisillness
  • the nature and purpose of thetreatment
  • theadvantages and risks ofthe treatment
  • the risks of not having the treatment

Also, thepatient’sillness must not affecthiscapacity to consent.If these criteria are met,thepatientcan consent to treatment onhisown.Of course, patients who are unconscious can’t consent to treatment.

Patients’ ability to make medical decisions can change over time. For example, patients with dementia may be able to make medical decisions one day but not the next because their condition fluctuates. Doctors must therefore evaluate patient’s capacity to consent on an ongoing basis.

Patients may be able to make some medical decisions but not others. For example, someone may be able to consent toacommon procedurelikeablood test, but not toamore complex procedure likean organ transplant.

Who Makes Decisions forAdultsWhoCan’t Consent?

Planning Ahead

Peoplecan express their wishes in advance in case they becomeunable tomakemedicaldecisions. For example, people cancreateadvance medical directives.

If a patientbecomesunable to makemedicaldecisionsand the patienthasadvance medical directives, the doctor must follow the instructions in thedirectives.

Who Can ProvideSubstituted Consent?

Ifthepatientdoesn’t haveadvance medical directives, these people can consent for the patient:

  • the patient’s legal representative (mandatary or tutor), if there is one
  • if there is no legal representative, the patient’s married or civil-union spouse, or common-law partner
  • if there is no spouse or partner, or if the spouse or partner can’t give consent, the patient’s close relative or someone concerned for the patient, like a close friend

Respecting the Patient’s Best Interests

Thepersonconsenting for the patientmust actinthe patient’sbestinterests.The benefits of the treatment must be greater than the risks involved.

Thepersonmustalsotake thepatient’s wishesinto account.Patientsmight have madetheirwishes knownaheadof time, for examplethroughaliving willor aprotection mandate.

The Court

Insome situations,thecourt mustmake medical decisions for patientswho can’tconsent on their own.The court’s permission is neededin these cases:

  • it’s impossible to get someone else to consent for the patient
  • the person who can give substituted consent refuses to consent for no good reason
  • the patient clearly refuses care required for their health

Exception:The court’s permission isn’t needed to giveemergencyor hygienic care to a person who can’tconsent on their own.Health care professionals can provide this care even if the patientrefuses.

Adults Who Can't Make Medical Decisions on Their Own | Éducaloi (2024)

FAQs

What is it called when someone can't make medical decisions for themselves? ›

Clinical incapacity to make health care decisions is the medical judgment of a qualified doctor or other health care professional who determines a person is unable to do the following: Understand his or her medical condition or the significant benefits and harms of proposed treatment and its alternatives.

What if an adult is unable to make medical decisions? ›

People can express their wishes in advance in case they become unable to make medical decisions. For example, people can create advance medical directives. If a patient becomes unable to make medical decisions and the patient has advance medical directives, the doctor must follow the instructions in the directives.

What happens when an older adult becomes incapable of making personal health care decisions? ›

If you do not have an advance directive and you are unable to make decisions on your own, the state laws where you live will determine who may make medical decisions on your behalf. This is typically your spouse, your parents if they are available, or your children if they are adults.

What is it called when you control someone's medical decisions? ›

A durable power of attorney for healthcare may also be called a “medical power of attorney” or “healthcare power of attorney.” This document, which should be notarized, designates a proxy or surrogate to act as a decision maker for your care and treatment in the event you are incapacitated by illness or injury and ...

What is it called when someone can t make decisions for themselves? ›

Aboulomania (from Greek a– 'without', and boulē 'will') is a mental disorder in which the patient displays pathological indecisiveness. The term was created in 1883 by the neurologist William Alexander Hammond, who defined it as: 'a form of insanity characterised by an inertness, torpor, or paralysis of the will'.

What do you call a person who Cannot make their own decisions? ›

Definition of indecisive. as in unsure. unable or slow to make decisions I was feeling indecisive, so it took me a while to pick a movie. He's always been an indecisive person.

What are the signs of incapacity? ›

Although each individual is different, there are some common and observable signs that someone is incapacitated or approaching incapacitation, including slurred or incomprehensible speech, unsteady gait, combativeness, emotional volatility, vomiting, or incontinence.

Who is next of kin for medical decisions in the USA? ›

Adults. In most states, the default surrogate decision maker for adults is normally the next of kin, specified in a priority order by state statute, typically starting with the person's spouse or domestic partner, then an adult child, a parent, a sibling, and then possibly other relatives.

What happens when an adult Cannot take care of themselves? ›

Get help from Adult Protective Services if you are concerned an adult may be self-neglecting. If a vulnerable adult chooses to be neglectful, you must respect his or her choice in any attempt to help.

What do you do when a patient cannot make a decision? ›

When a patient lacks decision-making capacity, the physician has an ethical responsibility to:
  1. Identify an appropriate surrogate to make decisions on the patient's behalf: ...
  2. Recognize that the patient's surrogate is entitled to the same respect as the patient.
  3. Provide advice, guidance, and support to the surrogate.

What makes someone incompetent for medical decisions? ›

Ability to Manipulate Information Rationally

If patients are unable to use logic and unable to weigh information in a rational manner to reach a decision, they will therefore be unable to compare the benefits and risks of various treatment options or interventions proposed to them.

What are the four types of medical decision-making? ›

Based on Medical Decision Making◄

►Four types of MDM are recognized: straightforward, low, moderate, and high.

What is it called when someone can no longer make decisions for themselves? ›

We Can Help

In North Carolina, incapacity is a legal term that refers to when someone can no longer make decisions for themselves. It can be due to age, illness, or injury. If you find yourself in this situation, it's crucial to have a plan in place for who will take care of you and make decisions on your behalf.

What is it called when a person Cannot take care of themselves? ›

Self-neglect is a general term used to describe a vulnerable adult living in a way that puts his or her health, safety, or well-being at risk.

What is the psychology behind inability to make decisions? ›

The indecisive mindset lacks a sense of self-efficacy.

Decisiveness flows from confidence that one can problem-solve the unwanted consequences of their decisions (high self-efficacy). In contrast, indecisiveness lurks when one expects to find potential unwanted consequences overwhelming (low self-efficacy).

What disorders are unable to make decisions? ›

This is a diagnosable mental disorder. “Aboulomania is when a person shows signs of pathological indecisiveness,” Perlus explains. “While most people will be indecisive at some point, people with aboulomania are indecisive to the point where it is an obsession and severely affects their daily lives.”

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