A 67-year-old man with metastatic pancreatic cancer refuses hospitalization for cholangitis and asks for oral antibiotics at home. He understands

Question

A 67-year-old man with metastatic pancreatic cancer refuses hospitalization for cholangitis and asks for oral antibiotics at home. He understands that he may die without intravenous antibiotics and drainage, explains his reasoning, and consistently states that being at home is his priority. He is not delirious or psychotic. His daughter demands admission. Which of the following is the most appropriate management?

Accepted Answer

Respect his informed refusal and arrange goal-concordant care

Answer

Declare him incapacitated because the decision is high risk

Answer

Withhold symptom treatment because he refuses admission

Answer

Seek a court order for treatment in every refusal

Answer

Admit him because family preference overrides refusal

Capacity and informed refusal — ABIM Board MCQ