gms | German Medical Science

Background/research question: Objective: Decisional capacity is an important requirement for legally justified assisted suicide in many countries. While several instruments have been developed over the past few decades to assess the capacity to consent to treatment, little is known about their applicability to assessing capacity in the context of requests for assisted suicide.

Methods: Methods: Review of instruments assessing decisional capacity published up to March 2024. Data concerning criteria for determining decisional capacity, psychometric properties and other aspects were extracted from all instruments included. Selected instruments were analyzed regarding their applicability to requests for assisted suicide.

Results: Results: We identified 23 instruments assessing capacity to consent to treatment. There is considerable heterogeneity regarding the criteria utilized for assessing decisional capacity and their operationalization. Next to cognitive abilities, some instruments incorporated emotions and values. Five instruments were assessed for applicability to requests for assisted suicide. The framing of decisional capacity within the context of disease and treatment options frequently prevents application of instruments to assess decisional capacity.

Conclusion: Conclusions: Normative and empirical work is needed for developing an instrument which could be applied to assess decisional capacity in the context of requests for assisted suicide.

Competing interests: Wissenschaftliche Arbeiten der Autor:innen zum Thema werden durch Drittmittel gefördert.