How can a decision of competence be determined?

• A. By a court of law
• B. By a mental health professional evaluation
• C. Only by a court of law
• D. By patient self-report

Answer: (C)

Competence is a legal status, not just a clinical judgment. A person’s ability to make binding decisions about money, personal care, or medical treatment is determined through a court proceeding, which can appoint guardians or conservators if needed. A mental health professional can assess a person’s decision-making abilities and provide expert input, but that assessment alone does not make or break legal competence. Likewise, relying on a person’s own report is not enough to establish legal competence, since self-perception may not reflect the broader legal standard. So the court's ruling is the authoritative determination of legal competence, making it the best answer.