The aim of this second of two articles is to consider a range of situations in which practitioners may find respecting an adult patient’s right to autonomy challenging. There will be opportunities to reflect on practice, and consider how best to manage such situations should they arise. Completion of the learning activities in this article will enable the reader to recognise situations where making an assessment of a patient’s capacity would be appropriate, determine who should make the assessment of capacity, take reasonable measures to support patients with impaired capacity in the decision-making process, recognise situations where it is appropriate for decisions to be made on behalf of a patient and identify situations where it will be necessary to undertake further action in relation to a proxy decision.