skip to main content

Incapacity during STEMI refusal — RCPSC EM MCQ

Instant feedback + full explanation. One question, done properly.

HardPsychiatric emergenciesIncapacity during STEMI refusalRCPSC EM

A 50-year-old man with schizophrenia has chest pain and an ECG showing anterior STEMI. He refuses treatment because he believes the ECG machine is transmitting commands from aliens. He cannot explain the consequences of refusal. What is the most appropriate next step?

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

Reveal the answer and explanation

Correct answer: C — Treat under emergency authority while documenting incapacity and best interests

Capacity is decision-specific. Psychosis preventing understanding and appreciation of a life-threatening STEMI permits emergency treatment under applicable provincial law while documentation and substitute decision-maker efforts proceed.

Reference: Canadian medicolegal emergency medicine practice; provincial consent legislation