In civil law contexts, forensic psychology can assess which of the following competencies?

• A. Competency to stand trial
• B. Competency to make medical decisions
• C. Competency to execute a contract
• D. Competency to commit a crime

Answer: (B)

Medical decision-making capacity is the type of competency most routinely assessed by forensic psychologists in civil law settings. It refers to whether a person can understand information about a medical condition and treatment, appreciate the consequences of different choices, reason about options, and communicate a clear, consistent decision. Courts rely on this decisional capacity to determine if someone can consent to or refuse treatment, participate in advance directives, or appoint a surrogate decision-maker. In forensic evaluations, the assessment focuses on the elements of understanding, appreciation, reasoning, and communication, applying standardized criteria to the individual’s specific medical context. This civil focus distinguishes it from competence to stand trial, which concerns the defendant’s ability to participate in criminal proceedings, and from capacity to contract or other civil capacities, which involve different standards and contexts. The concept of capacity to commit a crime does not align with civil competency, since criminal responsibility hinges on mental state at the time of the offense. Hence, medical decision-making capacity is the best fit for civil-forensic assessments.