Capacity refusal — DipIMC MCQ
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Correct answer: A — Assess and document capacity, risks discussed and safety-netting
Explanation lettering: D = shown as A · C = shown as B · A = shown as C · E = shown as D · B = shown as E
D is correct: A capacitous adult can refuse care, but the assessment and advice must be clearly documented. A is less suitable because it does not address the discriminator in the vignette; B is less suitable because it creates avoidable delay in a time-critical presentation; C is less suitable because it does not address the discriminator in the vignette; E is less suitable because it moves the patient before the decisive threat or destination issue is addressed. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.
Reference: JRCALC Guidelines; GMC Good Medical Practice; JESIP Joint Doctrine