Do Clinicians Follow a Risk-Sensitive Model of Capacity-Determination? An Experimental Video Survey

The authors asked whether clinicians use a risk-sensitive model for decisional-capacity determinations; that is, whether a higher degree of capacity was required in higher-risk situations. The respondents were randomly assigned to view a videotaped “capacity” interview of a medicationrandomized clinical trial scenario (N = 52) or a neurosurgical clinical trial scenario (N = 47). A significant scenario effect was mediated by the respondents’ perception of scenario-specific risk. Respondents showed considerable disagreement within each scenario that was not explained by clinician-specific factors. Thus, clinicians, in fact, use the normative risk-sensitive model for capacity, but there remains considerable unexplained variability in their judgments.