Decision-Making Capacity in Rehabilitation Psychology Practice: Historical, Contemporary, and Future Perspectives

Purpose: This article will review the historical underpinnings of informed consent and decisional capacity, current practices, and potential evolving future modifications or elaborations of decision-making practices in clinical settings. Method: Ethical and legal foundations for informed consent for health care are reviewed. Contemporary issues with decision making, clinical capacity, and proxy decision making in rehabilitation psychology practice are discussed with a specific focus on health care decision making. Conclusions: As a subspecialist in psychology, a rehabilitation psychologist necessarily seeks to incorporate a working knowledge of its historical anchors while simultaneously seeking changes sensitive to honoring and advocating for the rights of the individuals whom they serve. The contributions of the disability rights movement have been immeasurable in ensuring that those most impacted with potential challenges to their right to self-determine their choices across a wide range of psycholegal issues are safeguarded. As rehabilitation psychologists, we must remain steadfast stewards and constructive supporters of those under our care through protecting and advocating for their rights.