Praxis Medical Insights

The American Academy of Periodontology recommends that patients must have the ability to understand, appreciate, reason about, and express a choice regarding medical information, which includes understanding basic information about the proposed intervention, appreciating one's medical condition, reasoning to weigh risks and benefits, and expressing a preferred option 1, 2
Decision-specific capacity is recognized as a modern approach, where patients may retain the ability to make simpler decisions while lacking capacity for more complex ones, and assessment should be tailored to the specific decision at hand 1, 2

The American Academy of Pediatrics recommends disclosure of material information, including risks and benefits of the proposed intervention, relevant alternatives, and the option of no treatment, to ensure patients are well-informed 1, 3
Clinicians should provide a professional recommendation for a plan of care, and patients should demonstrate comprehension of the disclosed information 1

The American Academy of Periodontology suggests that informed consent involves a decision made by the patient in favor of a plan, and authorization provided by the patient to proceed with the chosen plan, which can be verbal or written 1
A shared decision-making model is preferred, where clinicians and patients work together to decide on the best care options, moving beyond simply providing information to active collaboration between provider and patient 1

Special Considerations

For patients with cognitive impairment, capacity assessment should be decision-specific, and surrogate decision-makers may be needed for those lacking capacity 1, 4
Informed consent is both an ethical obligation and a legal requirement for physicians, with two main legal standards existing: the "reasonable-patient" standard and the "reasonable-physician" standard 3, 5, 6