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Capacity assessment after intoxication resolves — RCPSC EM MCQ

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ModerateEthics, medicolegal, Indigenous healthCapacity assessment after intoxication resolvesRCPSC EM

CTAS 3: A 52-year-old treated for alcohol intoxication now has normal vitals and GCS 15. CT head obtained for a fall is normal. He understands the diagnosis, proposed observation, risks of leaving and alternatives, and can explain a plan to stay with a sober friend. He refuses further observation. What is the most appropriate disposition?

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Correct answer: E — Discharge against medical advice with documentation and return precautions

Capacity is decision-specific and time-specific. If the patient can understand, appreciate, reason and communicate a choice after intoxication resolves, a capacitated refusal should be respected and documented.

Reference: CanMEDS Professional role; Canadian medicolegal capacity principles