Three Kinds of Decision-Making Capacity for Refusing Medical Interventions

Figures & data

Figure 1. Types of decision-making capacity for refusal.

Table 1. Summary of differences between three kinds of decision-making capacity for refusal.

Burdens-based Refusal	Goals-based Refusal	Comparative Refusal
A patient must have partial understanding and appreciation of all proposed treatments, such that they can recognize that their reason for rejecting treatment is that each potential treatment involves at least one burden they overridingly reject.	A patient must have partial understanding and appreciation of all proposed treatments, such that they can recognize that each potential treatment will not promote their overriding goal of non-treatment or other goals that are inconsistent with medical interventions (e.g. going home).	A patient must have understanding, appreciation, and be able to comparatively reason about their prognosis and the nature and likely risks and benefits of all proposed treatments (including non-treatment) in light of their goals and values.