Assessing decision-making capacity: the clinical basics

Estimated Duration: 
1 hour

GPs are in a good position to assess the mental capacity of their patients and it is within the scope of practice of ALL medical practitioners to assess decision-making capacity and obtain informed consent.

GPs have an existing therapeutic relationship with their patients and the benefit of understanding their psychosocial background and longitudinal presentation, which can help in detecting any significant change from their premorbid cognitive functioning and decision-making ability.  

This course is part 1 of a 2-part module:

  • In this course, Assessing decision-making capacity: the clinical basics you will learn about the relevant principles when assessing decision-making capacity, and learn how to perform a capacity assessment using a 3-stage approach.
  • In course 2, Decision-making capacity: the legal aspects you will learn about the requirements for a formal assessment. This is important as you need to understand the legal framework for substitute welfare and financial decision-making to support people who may lack capacity to make decisions for themselves.

At the end of this course, you will be able to:

  • Understand the definition of decision-making capacity and informed consent;
  • Understand the four abilities of capacity – understand, retain, use or weigh, and communicate;
  • Perform a capacity assessment using the 3 staged approach: preparing for the assessment; the assessment interview; after the interview;
  • Appreciate the importance of having a culturally responsive practice, and Tikanga Māori, when performing a capacity assessment.

End of Life Choice Act 2019

Capacity assessment under this legislation is not covered in this course.

Information, guidance, and training resources about assisted dying for health professionals are hosted on the MOH LearnOnline training platform.


Once you have completed this short course, you can download your certificate for 1 Continuing Professional Development (CPD) hour.


This course was created by Dr Gary Cheung (Psychiatrist, FRANZCP, Auckland) and Dr Alisha Vara (Registrar, Auckland Regional Psychiatric Training Programme) in partnership with Alison Douglass (Barrister, LLB MBHL, Dunedin) and Dr Greg Young (Psychiatrist, FRANZCP, Hawkes Bay) in 2018. The wider project team also includes Dr Fred Sundram (Psychiatrist, PhD, Auckland), Dr Marcus Henning (Associate Professor, PhD, Auckland), and Prof Ngaire Kerse (Professor, PhD, Auckland).

We especially acknowledge the contribution of Alison Douglass, 2014 recipient of the New Zealand Law Foundation International Research Fellowship. This course is based on the Toolkit for Assessing Capacity from Alison’s mental capacity report co-authored with Dr Greg Young and Professor John McMillan.

The material is presented by the Goodfellow Unit (GFU), an accredited continuing medical education/ continuing professional development (CME/CPD) provider for the Royal New Zealand College of General Practitioners and functions under a tripartite agreement between the Goodfellow Foundation, the College and the University of Auckland. The Unit is located within the Department of General Practice and Primary Health Care, and within the School of Population Health.


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