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In law, competence refers to a person's legal authority or ability to make and communicate a decision, particularly concerning medical treatment. This concept is fundamental to respecting individual autonomy. While medical tests can assess capacity, the ultimate determination of competence is a legal one. A person is presumed competent unless their illness or disability demonstrably affects their ability to make a decision.1

The functional competence test requires an individual to comprehend and retain treatment information, believe that information (unless the disbelief stems from a delusion), and be able to weigh factors to communicate a choice. This legal standard for competence is similar across various jurisdictions, including the United States, the United Kingdom, Australia, New Zealand, and Canada. Competence and jurisdiction are related, with competence defining a court's legal ability to handle specific matters.12

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