What is the difference between capacity and informed consent in end-of-life decisions?

• A. Capacity is about the person's decision-making preferences; informed consent is about legal authorization.
• B. Capacity is the ability to understand and decide; informed consent requires understanding, appreciation of consequences, and voluntary decision.
• C. Capacity and informed consent are the same concept.
• D. Informed consent requires capacity but not understanding consequences.

Answer: (B)

Capacity is the person’s ability to understand information, reason about options, and communicate a choice at a specific time. It can vary and is decision-specific. Informed consent is the ongoing process by which a clinician provides information, verifies that the person understands and appreciates the consequences, and ensures the decision is voluntary. In other words, capacity is about the underlying ability to decide; informed consent requires that capacity plus understanding, appreciation of consequences, and voluntariness be demonstrated. In end-of-life decisions, assess capacity first; if present, obtain consent through a transparent disclosure and a voluntary, informed decision. If capacity is lacking, involve a surrogate or rely on advance directives.