Case Study: Evaluating Decision-Making Capacity in Healthcare Setting

This case study examines the decision-making capacity of Mr. S, a patient with potential intellectual disabilities, who wishes to leave the hospital against medical advice (AMA). The assignment explores the complexities of assessing a patient's ability to understand their condition, the consequences of their choices, and the implications for their healthcare. It discusses the ethical considerations surrounding patient autonomy, particularly when intellectual disabilities are present, and the importance of providing adequate information to facilitate informed decisions. The analysis considers factors such as the patient's understanding of their health needs, their ability to communicate their preferences, and the potential impact of non-adherence to treatment plans. The case highlights the need for healthcare providers to balance patient rights with the responsibility of ensuring appropriate care, emphasizing the importance of communication, education, and a thorough assessment of decision-making capacity before determining the best course of action.

Running head: EVALUATING DECISION-MAKING CAPACITY
EVALUATING DECISION-MAKING CAPACITY
Name of the student
Name of the university
Author’s name

EVALUATING DECISION-MAKING CAPACITY
Based on the information you have so far, does it appear that Mr S has
decision-making capacity to leave the hospital AMA?
The health needs people with intellectual disabilities have still under professional, legal
and ethical concern. People having intellectual disabilities have different health care needs as
compared to other people because of a reduced intellectual ability. There are a number of factors
that explain the poor health status because of a lower awareness of their health care needs
associated with disability (Fisher et al., 2009). Evidences have shown that adults having
intellectual disabilities are generally not involved in the decision making process and it has also
been noticed that they are denied of accessing the healthcare services (Atluru, 2016).
Considering the case scenario of Mr S, he should not be involved in the decision making process
since he lacks the ability to understand the severity his condition and the health needs addressing
his health concerns. The first criteria is to access the ability of the patient to understand the
pertinent medical information that he seems to be unaware of. He is also unaware of his situation
and the consequences he could have on skipping his antibiotic schedule. However, he shows
proper reasons to get back home and he also has the ability to communicate his choice with the
medical providers. Thus, there can be matter of conflict whether he should be involved in the
decision making process or not. Conversely, looking deeper into the matter, the decision making
criteria states that the patient should have the ability to comprehend the significance of the
treatment strategies, the medication prescribed and the consequences or impacts of failure to
adhere to the treatment strategies, which the patient seems to be lacking. He was ignorant of his
condition and prioritize his family more than his health. Therefore, from the healthcare’s

EVALUATING DECISION-MAKING CAPACITY
perspective, Mr S is not eligible for involving in the decision making process (Palmer &
Harmell, 2016).
What additional information would you like? What would be your next step?
It is important to provide Mr S with the required information about his health and all the
potential risks associate with his non-adherence to the treatment plan. He should be made
educated about his current health status and the need to follow the treatment strategies in order to
improve his health outcome through proper communication. Then, he should be interrogated to
assess his concerns and his perceptions regarding the treatment followed for his wellbeing.
However, in this stage, if he disagrees with the heath professional, it is difficult to manage the
situation since it will be against ethics. Every patient should be treated equally and should be
involved in the decision making process and their autonomy should be acknowledged and
respected, provided they are given with proper information (Charles et al., 2017).

EVALUATING DECISION-MAKING CAPACITY
References
Atluru, A. (2016). Revisiting Decision-Making Capacity. American Journal of Psychiatry
Residents' Journal, 11(11), 11-12.
Charles, L., Parmar, J., Brémault-Phillips, S., Dobbs, B., Sacrey, L., & Sluggett, B. (2017).
Physician education on decision-making capacity assessment: Current state and future
directions. Canadian Family Physician, 63(1), e21-e30.
Fisher, K. M., Orkin, F. K., Green, M. J., Chinchilli, V. M., & Bhattacharya, A. (2009). Proxy
healthcare decision-making for persons with intellectual disability: perspectives of
residential-agency directors. American journal on intellectual and developmental
disabilities, 114(6), 401-410.
Palmer, B. W., & Harmell, A. L. (2016). Assessment of healthcare decision-making
capacity. Archives of Clinical Neuropsychology, 31(6), 530-540.