If you suspect the consumer does not have the capacity or competence to make an enrollment decision, what should you do?

In situations where there is suspicion that a consumer lacks the capacity or competence to make an informed enrollment decision, the appropriate course of action is to refrain from completing the enrollment process. This decision is rooted in ethical considerations and the necessity of ensuring that individuals can fully understand and consent to the decisions being made about their healthcare.

Completing the enrollment without fully confirming the consumer's ability to participate in the decision-making process could lead to a number of complications. It may not respect the consumer's autonomy or rights, and could result in choices that might not align with their best interests or needs. It is essential to protect individuals who may be vulnerable and require additional support or clarification before making such important choices.

Involving family members or other agents, while possibly helpful, does not substitute for ensuring that the consumer is competent to make decisions on their own behalf. Therefore, the most appropriate response is to avoid completing the enrollment until a clearer understanding of the consumer's capacity is established.