To the extent possible, all treatment should be based on the patient s voluntary and informed consent. However, the capacity to consent may be impaired or limited for several reasons, and the legal competence to consent may thus not be present. There are several legal requirements which pertain to the patient s capacity to consent. In order to assess the consent such requirements have to be addressed by the responsible healthcare professional, which in most cases will be the doctor.
In Norway, however, the legal directions are to some extent rather complex. This paper first and foremost aims to identify and clarify legal regulations relevant to assess the patient s capacity to consent, and furthermore to identify important questions that are inadequately addressed by the law; i.e. areas where the law do not provide sufficient guidance in how to assess the patient s capacity to consent. Secondly, this paper explore whether medical students are sufficiently educated through a short questionnaire sent the medical faculties in Norway.
Some general questions which might be addressed when assessing decision-making capacity are discussed. Some examples on open issues not clearly solved by the legal guidelines are pointed out, with suggestions on how to solve these. These examples include the assessment of decision-making capacity for persons under guardianship, children, adolescence and adults. The results identify the need for health-care professionals to be sufficiently educated. The need for quality assurance systems in healthcare is also pointed out. Such systems might be assessment instruments, general guidelines, ethics committees or advocates services.