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Against medical advice documentation — ABEM Board MCQ

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EasyEthics, risk management, disposition, medicolegalAgainst medical advice documentationABEM Board

A 58-year-old woman with suspected NSTEMI wants to leave before admission. Triage acuity is ESI 2; BP 132/78 mm Hg, HR 92/min. She is oriented, can explain the risk of death and disability, and repeats return precautions. She refuses further care despite discussion. Which of the following is the most appropriate disposition?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Document capacity, risks, alternatives, return precautions, and offer ongoing care

When a capacitated patient refuses care, clinicians should document capacity assessment, informed refusal, alternatives, and return precautions while continuing reasonable care.

Reference: ACEP ethics guidance on informed refusal