A cooperative 23-year-old with autism spectrum disorder attends with his father. Who signs the informed consent?

Correct answer: C. The patient

• A. The presence of a parent at the appointment does not transfer consent authority.
• B. A social worker has no consent authority absent a formal court-appointed guardianship.
• C. CORRECT. Adults are legally PRESUMED to have capacity. A diagnosis of autism does not by itself remove decision-making capacity, and the stem specifically describes a cooperative patient. Unless a court has appointed a guardian, this patient consents for himself.
• D. A parent has no legal authority to consent for a competent adult child, regardless of how involved they are in the patient's care.

Note: The question you should actually ask at the visit: 'Has a legal guardian been appointed?' If yes, obtain and file the documentation and the guardian consents. If no, the patient consents — and you should still involve the father in the discussion with the patient's agreement, since supported decision-making produces better outcomes than either extreme.