Stimulus - Learn Tools to Crush It in Your Medical Career Do You Know the Difference Between Competence and Capacity?
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Sep 22, 2025 Rich Orman, a former deputy district attorney turned filmmaker, dives into the crucial distinctions between competence and medical decision-making capacity. He explains why someone can appear lucid yet still lack the capacity to make decisions about their care. Rich shares legal definitions, common courtroom pitfalls for physicians, and how to effectively testify, emphasizing the importance of clarity over jargon. Plus, enjoy a humorous tale involving an unexpected dog injury and the quirks of emergency care.
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Patient With MI Refuses Care
- A man with a clear acute MI refused admission because he wanted to sell his truck first.
- Rob described spending 30 minutes explaining risks while the patient repeatedly declined despite understanding consequences.
Competence Versus Capacity Are Different
- Competence and capacity are distinct: competence is a legal determination while capacity is a clinical assessment.
- Using the correct term in documentation matters because they have different decision-makers and implications.
Who Decides Competence And Capacity
- Competence is typically a legal judgment made by a judge about abilities like standing trial.
- Doctors decide on decision-making capacity at the bedside but may send complex cases to court.