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Consent, capacity and the right to say no

Peter D Bastian, Adeleen Eng, Linley A Denson and Lynn Ward
Med J Aust 2015; 202 (8): . || doi: 10.5694/mja14.01750
Published online: 4 May 2015

To the Editor: Snow and Fleming identify an important and often ignored problem.1 Without commenting on their specific case, we would point out that assessing a patient's medical decision-making capacity is part of every medical encounter,2 usually as an informal process and often without deliberative thought.


  • 1 Northern Adelaide Local Health Network, Adelaide, SA.
  • 2 University of Adelaide, Adelaide, SA.



Competing interests:

No relevant disclosures.

  • 1. Snow HA, Fleming BR. Consent, capacity and the right to say no. Med J Aust 2014; 201: 486-488. <MJA full text>
  • 2. Tunzi M. Can the patient decide? Evaluating patient capacity in practice. Am Fam Physician 2001; 64: 299-308.
  • 3. Bastian P, Ward L, Denson L. Pitfalls in medical practitioners' assessment of decision-making capacity. Psychiatr Psychol Law 2015. In press.
  • 4. Ganzini L, Volicer L, Nelson W, Derse A. Pitfalls in assessment of decision-making capacity. Psychosomatics 2003; 44: 237-243.
  • 5. Darziņs P, Molloy DW, Strang D. Who can decide? The six step capacity assessment process. Adelaide: Memory Australia Press, 2000.
  • 6. Purser KJ, Rosenfeld T. Evaluation of legal capacity by doctors and lawyers: the need for collaborative assessment. Med J Aust 2014; 201: 483-485. <MJA full text>
  • 7. Vellinga A, Smit JH, van Leeuwen, et al. Instruments to assess decision-making capacity: an overview. Int Psychogeriatr 2004; 16: 397-419.

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