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Capacity and refusal of treatment — DIPIMC MCQ

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HardScene Safety and MedicolegalCapacity and refusal of treatmentDIPIMCDipIMC

A 50-year-old with a painful but isolated closed ankle fracture declines to be taken to hospital. He is fully alert, understands that he may have a fracture and the risks of refusing care, and can communicate his decision. He has not taken alcohol or drugs. What is the most appropriate action?

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Correct answer: A — Respect his capacitous decision after explaining the risks

An adult is presumed to have capacity, and capacity requires the ability to understand, retain and weigh the relevant information and to communicate the decision; this alert, unintoxicated patient who understands his injury and the risks of refusal meets that test and may decline care. A capacitous refusal must be respected even if it appears unwise, so transporting him against his wishes, sedating him or using the police to compel him would be unlawful. Being in pain does not in itself remove capacity. Pearl: document the capacity assessment and the information given, including safety-netting and how to re-contact the service, and seek to persuade rather than coerce.

Reference: Mental Capacity Act 2005; Faculty of Pre-Hospital Care (RCSEd)