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Polypharmacy — CCFP MCQ

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HardGeriatricsPolypharmacyCCFP

An 82-year-old with mild dementia refuses a recommended hip operation. She consistently explains the fracture, alternatives and foreseeable consequences, and her choice reflects longstanding priorities. Her son demands consent on her behalf. What should the physician do?

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

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Correct answer: E — Respect her informed refusal after documenting a decision-specific capacity assessment

Explanation lettering: D = shown as A · E = shown as B · A = shown as D · B = shown as E

B is correct. Capacity is decision-specific and rests on understanding and appreciation, not diagnosis or age; a capable patient controls consent and may refuse beneficial treatment. C improperly displaces her. D delays care without a capacity dispute requiring adjudication. E misuses emergency authority. A substitutes screening for a clinical assessment. The team should manage pain, revisit questions and document the information, reasoning and voluntary choice.

Reference: CMPA: Consent—A guide for Canadian physicians: https://www.cmpa-acpm.ca/en/advice-publications/handbooks/consent-a-guide-for-canadian-physicians