Patient Rights The major objective of informed consent is to give the patient an opportunity play a role in his health care decision. The law requires physicians to get an informed consent of their patients before any medical procedure. The patient has a right to be informed and to be made aware of the nature of the procedure, available alternatives to the medical operation, the risks, benefits and uncertainties related to the operation as well as the patient's acceptance of the operation.

For a patient's consent to be valid, he must be considered competent to voluntarily make the decision (Edwards, 1998). However, there are conditions that may render a patient incompetent to make treatment decisions. In the case of Mr. Jones who has been diagnosed with Alzheimer's disease, the law provides for an option. According to section 5 article a of the National Conference of Commissioners;

"A surrogate may make a health-care decision for a patient who is an adult or emancipated minor if the patient has been determined by the primary physician to lack capacity and no agent or guardian has been appointed or the agent or guardian is not reasonably available" (National Conference of Commissioners, 1993).

In Mr. Jones case, that person is his adult daughter as stipulated in section 5 article b, 2. With this understanding, the process is legally seen as an invitation to Mr. Jones through his daughter to participate in his health care decision. The medical practitioners are also obligated to share their reasoning...

Medical ethics require the judgment of the involved parties to reflect a societal judgment about the perfect balance between respecting the patient's wishes and protecting him from the consequences of a bad decision (Appelbaum, 2007).
Determining capacity

It is recommended that physicians assess a patient's decision-making capacity more carefully when he refuses recommended treatment and not ready or willing or when the refusal is based on irrational reasoning or even without carefully considering the benefits of the operation (Tunzi, 2001 ). It is clear that Mr. Jones is competent, but the question is whether he has the capacity to understand the ranifications of his resusal, physicians are legally required to make decisions regarding the patient's capacity not competency ( p. 300). In the presented senerio, the social worker commented that Mr. Jones's daughter might have been afraid of an elder-neglect investigation if her father died. In order to clarify such claims, it is advisable for Mr. Jones primary care to perform the capacity assessment. This is because the primary physician is aware of his medical situation and the question at hand. The primary physician may also be in the best position to understand the family's values and religious views. In addition, this provides the benefit of medical history and an establishment of an ongoing medical relationship with the patient (Grisso & Appelbaum, 1998).

Capacity Assessment

Legally,…