Communication and Professionalism — Obtaining informed consent

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Case 1 of 6Communication and ProfessionalismObtaining informed consent (e.g., capacity assessment)

An 81-year-old man with mild dementia (MMSE 24/30) is admitted for management of a large gastric ulcer with active bleeding. The surgical team recommends urgent endoscopy with possible intervention. When you explain the procedure and its risks, benefits, and alternatives, he repeats back the key information in his own words, explains why the procedure is being recommended, and states he understands he could decline and what might happen if he does — but he becomes intermittently confused about the date and location. His daughter, who is not his substitute decision-maker, asks you to 'just do the procedure, he's confused, I'll sign for him.'

Question 1 of 17

Which ONE of the following is the most appropriate next step?

Select 1. (0 / 1 selected)

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AAssess and document the patient's capacity to consent to this specific decision

BWithhold the procedure until a formal court-appointed guardian is assigned

CProceed with the procedure based on the daughter's consent

DAsk the daughter to become the substitute decision-maker immediately

EDelay the procedure until the patient's MMSE improves

FProceed without consent because it is an emergency

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