Does this skill account for fluctuating capacity?

Yes, it includes steps to identify and treat reversible factors like delirium, medication effects, and metabolic derangements before concluding incapacity.

How does the sliding-scale model apply to assessments?

The skill adjusts the capacity threshold based on the risk-benefit profile: higher-risk decisions require a more robust demonstration of reasoning and understanding.

What framework does this skill use for capacity evaluations?

It uses the universally adopted Appelbaum four-abilities framework: understanding, appreciation, reasoning, and expressing a choice.

What is the difference between capacity and competency?

Capacity is a clinical determination made by healthcare providers for specific decisions, while competency is a legal status determined by a court.

Medical Capacity Evaluation Guide

Name: Medical Capacity Evaluation Guide
Author: lev-os

bylev-os

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Learning & Documentation

Standardizes medical decision-making capacity assessments using the evidence-based Appelbaum four-abilities framework.

This skill provides a structured clinical framework for conducting medical decision-making capacity evaluations, essential for psychiatric consultations and legal-medical documentation. It guides users through the Appelbaum criteria—understanding, appreciation, reasoning, and expressing a choice—to determine if a patient can provide truly informed consent. By incorporating delirium screening (CAM/4AT), reversible factor identification, and the sliding-scale risk model, the skill ensures that clinical assessments are rigorous, ethically sound, and properly documented for healthcare and legal proceedings.

Key Features

01Sliding-scale risk-benefit capacity assessment

02Post-determination guidance for surrogate decision-makers

032 GitHub stars

04Structured delirium and reversible factor screening

05Clinical documentation templates for psychiatric evaluations

06Appelbaum four-abilities framework implementation

Use Cases

01Evaluating a patient's capacity to consent to or refuse high-risk surgery

02Assessing informed consent ability in cognitively impaired or delirious patients

03Documenting psychiatric consultations for medical decision-making

Key Features

01Sliding-scale risk-benefit capacity assessment

02Post-determination guidance for surrogate decision-makers

032 GitHub stars

04Structured delirium and reversible factor screening

05Clinical documentation templates for psychiatric evaluations

06Appelbaum four-abilities framework implementation

Use Cases

01Evaluating a patient's capacity to consent to or refuse high-risk surgery

02Assessing informed consent ability in cognitively impaired or delirious patients

03Documenting psychiatric consultations for medical decision-making