Capacity and refusal of treatment station

This station tests the principle that a person with capacity may refuse even life-saving treatment. The examiner wants a proper capacity assessment and respect for autonomy, not persuasion at any cost.

How to structure it

• Explore the reasons behind the refusal without judgement.
• Provide clear information about the risks and the alternatives.
• Assess capacity formally — understand, retain, weigh and communicate.
• If they have capacity, respect the decision and document it; if not, act in their best interests.
• Safety-net and arrange appropriate follow-up.

Common pitfalls

• Conflating an unwise decision with a lack of capacity.
• Pressuring or coercing the patient.
• Failing to document the assessment and decision.

Examiners reward a structured capacity assessment, respect for autonomy, and clear, non-coercive communication.