Assessing capacity for a specific pharmacy decision

The law uses a two-stage test. First, is there an impairment of, or disturbance in, the functioning of the mind or brain? Second, does that impairment mean the person cannot make the particular decision when it needs to be made?

What the person must be able to do

A person lacks capacity for a particular decision if they cannot do one or more of the following:

• Understand the information relevant to the decision.
• Retain that information long enough to make the decision.
• Use or weigh the information as part of deciding.
• Communicate the decision by any means.

Why this matters in pharmacy

Capacity issues can affect many pharmacy activities: vaccinations, emergency supplies, medicines-use reviews, clinical services, refusal of treatment, sharing information with relatives, and decisions about whether someone understands how to use a medicine safely.

Several common, temporary factors may reduce capacity: severe pain, delirium, intoxication, low blood glucose, exhaustion, acute illness, or sedating medicines. If the decision can safely wait, reassessing later is often preferable to proceeding at an inappropriate time.

Capacity can fluctuate. If the person is likely to regain capacity, avoid deciding for them if the decision can safely wait.