Which combination of assessments is used to determine decision-making capacity during holds?

• A. Standard identification checks alone.
• B. Capacity is determined by court order.
• C. Standard identification checks plus clinical capacity evaluations.
• D. Clinical capacity evaluations only.

Answer: (C)

Deciding if someone has the ability to make medical decisions during a hold requires two things: confirming who the person is, and assessing their actual decision-making ability. Verifying identity ensures you’re evaluating the right individual, but alone it doesn’t tell you anything about capacity. To determine capacity, clinicians conduct a clinical capacity evaluation that looks at whether the person understands information about the hold and proposed treatment, appreciates the consequences of decisions, can reason about options, and can clearly express a choice. Using both steps together—standard identification checks plus a clinical capacity evaluation—provides a reliable, timely assessment of decision-making capacity in the moment. Relying on identification alone misses cognitive ability, a court order is not how capacity is determined on the spot, and a clinical capacity evaluation by itself isn’t sufficient without confirming the person’s identity.