How do competency and capacity differ in medical decision-making?

• A. Competency is determined by the court; capacity is temporary and may be determined by any professional.
• B. Capacity is determined by the ER clinician; competency is determined by the court.
• C. They are the same concept and have identical implications.
• D. Capacity is permanent and unchangeable, while competency is temporary.

Answer: (C)

The main idea being tested is the patient’s ability to participate in medical decision-making. In this framing, capacity and competency are treated as the same general concept because both revolve around whether a person can understand information, appreciate consequences, reason about options, and communicate a choice regarding treatment. If someone has the ability to participate in the decision, they are considered capable; if not, a surrogate or protective measures come into play.

The answer that these terms are the same concept emphasizes that the practical outcome—whether a patient can consent or not—is the same, regardless of the terminology used. The other statements introduce distinctions about who decides (court versus clinician) or about permanence versus temporariness, which are real-world nuances but go beyond the core idea of deciding if the patient can actively participate in the decision.