Capacity and decision making

Pickering et al's paper argues that the capacity of the decision-maker is the sole consideration in whether a decision should stand, and that the risk of the decision should not be considered. This argument ignores the existence of the player who is of the view that a decision is not wise. This paper argues that patient autonomy is not the sole determinant of whether a person is able to make an unwise decision, particularly in healthcare where there are always others affected by the patient decision. Rather than asserting that patients have an unfettered autonomous choice on clinical decisions this paper argues that these decisions should be looked at through the lens of quality in health care that has proposed four parameters to be balanced; the patient experience, wise use of resources, the effect on public health and the clinician experience.

Automated summary

This paper argues that the capacity of the decision-maker should be the sole consideration in deciding whether a decision should stand, regardless of the risks involved. However, it fails to acknowledge the perspectives of those who question the wisdom of a decision. Instead, the paper suggests that healthcare decisions should be evaluated based on four parameters - patient experience, resource utilization, public health impact, and clinician experience - rather than solely relying on patient autonomy.