How can a healthcare administrator ensure that the patient’s autonomy is ensured and competency is established?

Note: Before completing this Discussion, please familiarize yourself with the Week 4 Discussion 2 Rubric, located in the Course Information area of the course navigation menu.

Patients’ rights in the United States include the right to informed consent, which means that patients must receive adequate information to make medical decisions. However, many questions can arise if a patient appears to lack the capacity to understand his or her medical condition or options.

As a health care administrator, it is your responsibility to educate medical staff about your facility’s policy on obtaining informed consent, reflecting state law, and how to determine whether a patient is competent. It is essential to balance the moral needs of protecting the rights of the patient with the legal and ethical obligations to breach this confidentiality in certain select situations, or determine circumstances requiring a surrogate decision maker.

Medical staff should have no difficulty in following a patient’s wishes specific to health treatment when the patient is a competent adult who can articulate his or her wishes to the medical team. However, what if the medical team is unable to determine competency? How would the team assess mental competency to understand benefits and risks of the medical treatment? If the patient is not competent, how should the medical staff proceed?

To prepare for this Discussion, view the first video in this week’s Learning Resources, “Incident in the ER: Scene 1”. Then, reflect on the delivery of health care services demonstrated in the video regarding determining competency. Reflect on the positive and negative aspects demonstrated and consider how health care administrators should consider these aspects when engaged in practice.

Post by Day 4 a response to the following questions in which you apply your understanding of ethical and legal principles to your analysis of the “Incident in the ER: Scene 1” video:

  • Who decides on behalf of the patient if the patient is determined to lack competency?
  • How should a surrogate decision maker proceed on behalf of a patient?
  • How can a healthcare administrator ensure that the patient’s autonomy is ensured and competency is established?
  • How do the facility’s standards and regulations affect how competency is determined?

General Guidance on Discussion Posts: Your original post, due by Day 4, will typically be 3–4 paragraphs in length as a general expectation/estimate. Refer to the Week 4 Discussion 2 Rubric for grading elements and criteria. Your Instructor will use the rubric to assess your work.

  • Medscape News [Medscape]. (2012, November 26). Keeping patients alive a few weeks more: Is it futile care? [Video file]. Retrieved from

    Note: The approximate length of this media piece is 7 minutes.

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