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Brain injury capacity assessment — SCE Neurology MCQ

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HardFunctional, Rehabilitation and DVLABrain injury capacity assessmentSCE Neurology

After frontal brain injury, a patient can repeat information but cannot consistently use or weigh it when deciding whether to accept rehabilitation. What is the correct legal-clinical approach?

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Correct answer: D — Assess this specific decision using communication support and the statutory capacity test

The best answer is “Assess this specific decision using communication support and the statutory capacity test”. Capacity is decision- and time-specific. The patient must be helped to understand, retain, use or weigh information and communicate a choice; repeating information alone does not establish capacity. The alternatives “Treat repetition of information as proof of capacity, when the phenotype supports it”, “Infer incapacity from refusal of the recommended rehabilitation plan, within the relevant UK pathway”, “Ask relatives to make the decision without assessing the patient”, “Use a global cognitive score as the sole capacity test” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: National Clinical Guideline for Stroke: acute care: https://www.strokeguideline.org/chapter/acute-care/