Which statement best describes decision-making capacity in relation to competency?

• A. It is determined by a court of law.
• B. It is the ability to make decisions and may vary by situation.
• C. It is always fixed and not situation-dependent.
• D. It is unrelated to patient autonomy.

Answer: (B)

Decision-making capacity means a person's ability to understand information about a decision, appreciate its consequences, reason about options, and communicate a choice. This ability is task-specific and time-sensitive, so it can vary depending on the situation or a person’s current state. Competency, by contrast, is a legal determination—often made by a court—about whether a person has the general ability to make decisions (or a specific kind of decision). Because capacity sits in the here-and-now, context matters and can change, while competency is a broader legal status that may not reflect every moment of decision-making ability. That’s why the statement that best describes the relationship is that decision-making capacity is the ability to make decisions and may vary by situation. It’s not determined by a court in normal practice, it isn’t always fixed, and it is central to respecting patient autonomy.