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Capacity in depression — MCCQE Part 1 MCQ

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ModerateConsent & CapacityCapacity in depressionMCCQE Part 1

A 62-year-old man with metastatic cancer and depression refuses chemotherapy but can explain his diagnosis, options, risks and reasons consistently. Which of the following is the most appropriate next step?

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Correct answer: CRespect the refusal if he has decision-specific capacity

Respect the refusal if he has decision-specific capacity is the single best answer because the age, timing, examination findings and investigations in the vignette fit Capacity in depression better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to CMPA consent guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: CMPA consent guidance