 There are now a number of published studies that report that depressed patients are often decisionally capable and compare well with matched controls (Appelbaum &amp; Grisso 1995; Vollmann et al. 2003; Appelbaum, Grisso, et al. 1999). However, what is being reported is that these patients did well when assessed using instruments like the MacCAT-T which is based on the four abilities model. Because the authors of the studies have faith in that model they clearly intend their results to license normative conclusions. However, critics worry that negative emotional outlooks can lead depressed patients to weigh risks and benefits differently (Elliot 1997; Rudnick 2002). Since such patients do not care as much about themselves or their own lives, they may not care about risks in the same way they would if not depressed. Such patients are cognitively intact: they understand the relevant facts and grasp that the facts apply to them. But depressed affect may still (so it is argued) undermine their ability to decide. More recently it has been suggested that those who assess the capacity of persons with severe depression may need to consider their ability to project themselves into the future as this may relate to hope or loss of hope that may impact on decision-making (Halpern 2012; Meynen 2011; Owen, Freyenhagen, et al. 2015; Owen, Martin, &amp; Gergel 2018). Some theorists have argued that affect and emotion play a central role in many other mental disorders, even those not necessarily thought of as disorders of affect. On that basis they have argued that the problems outlined here—problems related to the fact that the four-abilities model ignores emotion—may also arise with these patients. Examples include addiction (Charland 2011), patients with OCD (Ruissen 2015; Ruissen et al. 2016), and patients with anorexia nervosa (Charland, Hope, et al. 2013; Charland 2015).