Informed Consent

All adults have the legal right to make informed decisions about their bodies and their health care. Patients who are able to make their own decisions (see below) and who are fully informed have the right to refuse care—even if that choice may shorten their life.

Informed consent is important for safe, legal, and ethical (proper) health care and research in the United States.

Adults should make medical decisions after they:

  • Learn about their health problems.
  • Learn about the risks, benefits, and other treatment options.
  • Talk about this information with their healthcare professionals.

There are two situations when the usual process for getting permission may not apply:

  1. In a true medical emergency, doctors may need to act quickly to save a person’s life or prevent serious harm if the person, or their chosen decision-maker (called a surrogate), cannot respond in time.
  2. Sometimes a court decides that an adult is not able to make their own medical decisions.

What is Shared Decision-making?

Under “shared decision-making,” the adult and the healthcare professional work together to make health care decisions.

The adult is the expert on their own values and their goals for care and treatment. The healthcare professional is the expert on diagnosing illness and explaining treatment options.

Shared decision-making means the adult and healthcare professional talk about:

  • The adult’s understanding of their health condition (diagnosis)
  • The adult’s understanding of how serious the illness is and how it may affect their health and well-being (prognosis)
  • Reasonable treatment or care options
  • The risks and benefits of possible tests and treatments
  • The likely results of each test or treatment
  • The adult’s values, goals, and preferences

Decision-Making Ability

An adult’s ability to make decisions should be respected as much as possible. For example:

  • Disagreeing with a healthcare provider’s advice does not mean the adult cannot make decisions.
  • Choosing not to follow a provider’s recommendation is not, by itself, a reason to question someone’s decision-making ability.
  • Adults who cannot make decisions in one area (such as managing money) may still be able to make healthcare decisions. 
  • Adults with memory or thinking problems may still be able to make decisions.
  • Decision-making ability can improve over time.
  • Cultural, ethnic, or religious beliefs may influence a person’s decisions.
  • Decision-making ability can change. For example, delirium (sudden confusion) can cause temporary problems with thinking.

An adult’s ability to understand their health problems and treatment options can change. For example, a person with delirium (a sudden change in thinking and awareness) may be clear in the morning but confused later in the day. If an adult cannot make informed decisions, the healthcare professional should wait, if possible, until the adult can decide again.

Healthcare professionals must respect a person’s decisions.

Adults who are unconscious or who have severe mental health conditions may not be able to make decisions. In these cases, healthcare professionals must evaluate decision-making ability and involve the adult as much as possible.

Specialists such as geriatricians, primary care physicians, psychiatrists, and psychologists can help assess decision-making ability.

If an adult cannot make medical decisions, the healthcare team must identify the person who is legally responsible for making decisions on their behalf.

Determining an Adult’s Ability to Make Decisions

Medical Decisions 

Healthcare professionals can check a person’s decision-making ability by:

  • Talking with the person about the decision, including the risks, benefits, and other options. They should consider the person’s culture, education level, and communication style.
  • Making sure the adult can show understanding, appreciation (how it applies to them), reasoning, and the ability to clearly share a choice.
  • Checking whether the adult understands how the decision may affect their health.
  • Looking at whether the person’s choices are consistent over time.

Standard mental status tests may help. However, doing poorly on these tests does not automatically mean the person cannot make decisions. Some adults may need extra support, such as simpler explanations or more time, to understand their options.

Adults who are in a coma, cannot communicate, or cannot keep a consistent choice even after explanations likely cannot make medical decisions.

When adults cannot make decisions on their own, they need support. The healthcare professional should still include the adult as much as possible in decisions about their medical care.

Decisions About Self-Care

A healthcare professional can assess whether an adult can make decisions about self-care and living independently by asking whether the person:

  • Can take care of themself.
  • Shows good judgment and insight, including the ability to ask for or accept help to stay safe.

Finances

A healthcare professional can assess whether an adult can make financial decisions by checking if they can:

  • Pay their bills.
  • Do basic math and manage their money.

Last Will and Testament

A healthcare professional can help determine whether an adult can make decisions about a last will by assessing whether they can:

  • Remember their estate plans.
  • Explain the reasons for their choices.

Advance Directives

A healthcare professional can help an adult:

  • Complete advance directives, including a living will.
  • Choose a trusted person to serve as a healthcare power of attorney to make medical decisions if the adult cannot.


Last Reviewed and Updated: October 2026 
By: AGS/HiAF Public Education Committee, HealthinAging.org Content Reviewers 

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