University of California, San Diego Brief Assessment of Capacity to Consent
Jeste DV, Palmer BW, Appelbaum PS, Golshan S, Glorioso D, Dunn LB, Kim K, Meeks T, Kraemer HC. A New Brief Instrument for Assessing Decisional Capacity for Clinical Research. Arch Gen Psych 2007;64(8):966-974
1. What is the purpose of the study that was just described to you?
2. What makes you want to consider participating in this study?
3. Do you believe this is primarily research or primarily treatment?
4. Do you have to be in this study if you do not want to participate?
5. If you withdraw from this study, will you still be able to receive regular treatment
6. f you participate in this study, what are some of the things that you will be asked
7. Please describe some of the risks or discomforts that people may experience
if they participate in this study. (Please describe the 2 serious risks associated
with the study.)
8. Please describe some of the possible benefits of this study.
9. Is it possible that being in this study will not have any benefit to you?
10. Who will pay for your medical care if you are injured as a direct result
of participating in this study?