Which description best defines consent capacity and surrogate decision-makers?

• A. Capacity is the ability to understand information but not to decide.
• B. Capacity is the ability to understand information and make decisions, but surrogates are never used.
• C. Capacity means a patient can perform daily activities.
• D. Capacity is the ability to understand information and make decisions; surrogate decision-makers are used when a patient lacks capacity.

Answer: (D)

Consent capacity is about whether a patient can understand information about a medical option, weigh the risks and benefits, and communicate a clear treatment decision. Capacity is decision-specific and can vary over time; a person might have capacity for some choices and not for others, and professionals assess it in the moment of decision.

When someone lacks capacity, a surrogate decision-maker steps in—such as a legally appointed health care proxy or guardian—who makes choices based on what the patient would want (substituted judgment) or on the patient’s best interests.

That’s why this description fits best: capacity involves understanding information and making decisions, and surrogate decision-makers are used when a patient lacks capacity. The other statements are off because understanding alone doesn’t guarantee a choice, surrogates are used when capacity is lacking, and capacity is not defined by daily functional activities.