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Incapacity and emergency treatment — SCE Acute Medicine MCQ

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ModeratePerioperative Medicine, End-of-Life Care and Patient SafetyIncapacity and emergency treatmentSCE Acute Medicine

A 68-year-old man is assessed on the acute medical unit. He has sepsis, lacks capacity because of delirium and refuses cannulation. No advance decision or lasting power of attorney is known. Initial assessment includes relevant observations, bedside tests and urgent blood results. What would you advise this patient?

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Reveal the answer and explanation

Correct answer: E — Treat in the patient's best interests and document the rationale

Treat in the patient's best interests and document the rationale is the best answer because urgent necessary treatment can proceed in best interests when capacity is lacking and delay risks harm. Explain discharge safety-netting and provide written information is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Capacity is decision-specific and can fluctuate.

Reference: Mental Capacity Act Code of Practice