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Capacitous refusal of treatment for suspected sepsis — SCE Acute Medicine MCQ

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ModeratePatient Safety and Risk ManagementCapacitous refusal of treatment for suspected sepsisSCE Acute Medicine

A 68-year-old man refuses admission for suspected sepsis. He can explain that he may die without antibiotics, describes alternatives, weighs the risks and consistently states he wants to remain at home to care for his wife. There is no delirium or psychosis. What is the most appropriate next step?

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Correct answer: B — Respect the refusal while offering treatment, safety-netting and documentation

Capacity is decision-specific and a capacitous patient may refuse even life-saving treatment. A risky or unwise decision does not prove incapacity. Relatives cannot override a capacitous refusal. The clinician should optimise information, explore concerns, offer alternatives and document the capacity assessment and safety-netting.

Reference: Mental Capacity Act 2005 Code of Practice, GMC consent guidance