skip to main content

Capacitous refusal of invasive treatment in acute coronary syndrome — SCE Acute Medicine MCQ

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

HardMedicine in the elderlyCapacitous refusal of invasive treatment in acute coronary syndromeSCE Acute Medicine

A 79-year-old man with capacity is admitted with NSTEMI and recurrent chest pain. He understands that angiography may reduce risk of further infarction but refuses transfer because he wants comfort-focused care after recent bereavement. He can explain the consequences and is not delirious. What is the most appropriate next step in management?

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

Reveal the answer and explanation

Correct answer: A — Respect his refusal and document capacity, information given and the treatment plan

A capacitous adult can refuse treatment even if clinicians consider the decision unwise or life-shortening. Documentation should show the decision-specific capacity assessment, information provided, alternatives and ongoing symptom plan. Family can support discussion but cannot overrule a capacitous refusal.

Reference: Mental Capacity Act 2005 Code of Practice; GMC Decision making and consent