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Code status with capacitated patient — USMLE Step 3 MCQ

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HardEthics, Patient Safety, Quality Improvement, Systems-Based PracticeCode status with capacitated patientUSMLE Step 3

A 58-year-old man with metastatic lung cancer is hospitalized with pneumonia. He is awake and has capacity. He says he wants no intubation but wants antibiotics and noninvasive oxygen. His daughter says, 'Do everything, he is depressed.' Depression screen is negative and he consistently repeats his preference. Which of the following is the most appropriate next step?

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

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Correct answer: B — Honor the patient's informed preference and document code status

A capacitated adult's informed decisions supersede surrogate preferences. Treatment limitations can be specific; declining intubation does not mean declining antibiotics or oxygen.

Reference: AMA Code of Medical Ethics: decisions for patients with capacity