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Mnemonics, Simplified Concepts & Thoughts

Patient Decision Making Capacities – CURVES mnemonic

Epomedicine, Jun 27, 2020May 24, 2024

Last updated on May 24, 2024

a. Choose and communicate

  • Can the patient make a choice and communicate that choice?

b. Understand

  • Does the patient understand the risks, benefits, alternatives and consequences of the decision?

c. Reason

  • Can the patient provide logic or reason behind his/her decision?

d. Value

  • Is the choice the patient makes consistent with their values?

e. Emergency

  • Is there an impending, emergent risk to the life or limb?

f. Surrogate

  • Is there a decision maker available or advanced directives of the patient?

The first 4 letters (C-U-R-V) assess the Decision-Making Capacity of the patient. A paitent lacks capacity if any of these pre-requisite abilities are absent.

The last 2 letters (E-S) sssess whether emergency treatment can be delivered without Informed Consent. Treating with implied consent is only appropriate when the patient does not have capacity to make the decision (C-U-R-V), it is an Emergency (E), and there is no surrogate decision maker (S) available, i.e. lack all the 6 points of CURVES.

Reference:

Chow GV, Czarny MJ, Hughes MT, Carrese JA. CURVES: a mnemonic for determining medical decision-making capacity and providing emergency treatment in the acute setting. Chest. 2010 Feb;137(2):421-7. doi: 10.1378/chest.09-1133. PMID: 20133288.

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PGMEE, MRCS, USMLE, MBBS, MD/MS Ethics

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Comments (2)

  1. Dr.Prof. N.K.Gupta says:
    Jan 1, 2021 at 3:18 pm

    This is excellent piece of information, very helpful in clinical practice

    Reply
  2. Mnemonic says:
    Mar 11, 2022 at 11:00 pm

    Thank you very much. Thank you so much for explaining in such a beautiful way. Looking forward to your next post

    Reply

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Epomedicine. Patient Decision Making Capacities – CURVES mnemonic [Internet]. Epomedicine; 2020 Jun 27 [cited 2025 May 9]. Available from: https://epomedicine.com/medical-students/decision-making-capacities-emergencies-curves-mnemonic/.

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