Assessment of capacity in medical practice

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Patients must have capacity if they are to consent to medical treatment. Decisions on whether a person has, or lacks, capacity thus have significant implications. However, uncertainties often arise when health professionals are required to assess capacity. The SAMS medical-ethical guidelines provide guidance for everyday medical practice.

In the medical decision-making process, the presence or absence of capacity is of crucial importance. While capacity is generally assumed to be present, an assessment must be carried out in cases where reasonable doubts arise.


According to a study overseen by the Central Ethics Committee of the SAMS, physicians have major uncertainties with regard to the assessment of capacity (cf. Biller-Andorno N, Trachsel M: Decision-making incapacity at the end of life and its assessment in Switzerland.)


Based on the results of this study, the SAMS therefore developed medical-ethical guidelines on «Assessment of capacity in medical practice». These provide guidance for all health professionals involved in assessments of this kind. The guidelines define the principles to be observed in the assessment of capacity and describe the procedure to be adopted, both in general and in particular areas of medical practice (e.g. in general practice, emergency and intensive care, or palliative care). With the so-called «U-Doc», a form for evaluating the decision-making capacity is furthermore provided. This tool is presented and discussed in the following scientific publication: Decision-making capacity: from testing to evaluation (29.04.2020)



Print versions of the SAMS medical-ethical guidelines (in French/German) can be ordered free of charge. PDF versions (also in English/Italian) are available online. The U-Doc form is also available in other languages (French/German/Italian). Publications





lic. theol., dipl. biol. Sibylle Ackermann Birbaum
Head Department Ethics a.i.