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Capacity assessment — MCCQE Part 1 MCQ

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HardCapacityCapacity assessmentMCCQE Part 1

68-year-old man with diabetes presents with refusal of foot amputation. He explains infection risks, alternatives and consequences, and consistently refuses. Which of the following is the most appropriate next step?

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Correct answer: B — Respect the capable patient's informed refusal and document the capacity assessment

Respect the capable patient's informed refusal and document the capacity assessment is best because capacity is decision-specific and he demonstrates understanding/appreciation/reasoning/choice. Breach confidentiality broadly without legal basis is suboptimal because disclosure must be limited to what is legally authorised or clinically necessary; Let family preference override a capable patient is suboptimal because capable patients direct their own care; Refuse to discuss the issue and document nothing is suboptimal because professional practice requires communication and clear documentation; Delay a mandatory report until certainty is absolute is suboptimal because statutory reporting thresholds are often suspicion or reasonable belief, not proof. An unwise decision is not automatically incapacity.

Reference: CMPA consent and capacity guidance