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Substitute decision-making — RCPSC IM MCQ

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ModerateGeneral IM, Ethics, CanMEDSSubstitute decision-makingRCPSC IM

A 76-year-old man is admitted after a fall. He has mild dementia and no family present. He is stable but needs urgent hip-fracture surgery. He cannot explain the procedure, risks, or consequences of refusing. There is no advance directive on the chart. What is the most appropriate investigation?

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

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Correct answer: A — Identify the legally authorised substitute decision-maker

When a patient lacks decision-making capacity for a proposed intervention, the clinical team should identify the legally authorised substitute decision-maker according to local law and document the process.

Reference: CanMEDS professionalism framework; provincial consent law principles