The 45-year-old son of a client calls the PMHNP to ask her to write a letter declaring his mother incompetent, and therefore unable to make medical decisions for herself. What is the most appropriate response?

Choice A reason: This statement is dismissive and lacks clinical and legal assessment. Competence cannot be determined over the phone or without a formal evaluation. It also assumes facts not in evidence. Choice B reason: Competence is a legal determination made by a judge, not a medical provider. While clinicians can assess decision-making capacity, they cannot declare someone legally incompetent. This response is accurate and maintains professional boundaries. Choice C reason: This statement implies agreement with the son’s concern without proper evaluation. It may be interpreted as bias and could compromise the therapeutic relationship or legal standing. Choice D reason: While offering a referral is helpful, it does not address the core issue of legal authority. The PMHNP must clarify that competence is a legal matter, which is best done in option B.