PT - JOURNAL ARTICLE AU - Hass, Binesh TI - The values and rules of capacity assessments AID - 10.1136/medethics-2021-107923 DP - 2022 Nov 01 TA - Journal of Medical Ethics PG - 816--820 VI - 48 IP - 11 4099 - http://jme.bmj.com/content/48/11/816.short 4100 - http://jme.bmj.com/content/48/11/816.full SO - J Med Ethics2022 Nov 01; 48 AB - This article advances two views on the role of evaluative judgment in clinical assessments of decision-making capacity. The first is that it is rationally impossible for such assessments to exclude judgments of the values a patient uses to motivate their decision-making. Predictably, and second, attempting to exclude such judgments sometimes yields outcomes that contain intractable dilemmas that harm patients. These arguments count against the prevailing model of assessment in common law countries—the four abilities model—which is often incorrectly advertised as being value-neutral in respect of patient decision-making both by its proponents and in statute. A straightforward evaluative model of capacity assessment which wears its values on its sleeves and is biased against what are called ‘serious prudential mistakes’ avoids these rational and practical problems.Data sharing not applicable as no datasets generated and/or analysed for this study. Not applicable.