MARGINAL CAPACITY - THE DILEMMAS FACED IN ASSESSMENT AND DECLARATION

Ontario is adopting informed-consent legislation that reflects increas ing emphasis on patient autonomy and self-determination. Capacity asse ssment and declaration by physicians and other health care professiona ls are pivotal under the new legislation. While grossly capable or inc apable patients provide few management difficulties, marginally capabl e patients provide a challenge for physicians who must assess capacity , and decisions concerning them emphasize the ethical dilemma involved in any declaration of incapacity. Our 1994 Logie Medical Ethics Essay first-prize winner, Vincent Ho, examines the issues that clinicians m ust consider when assessing marginally capable patients.