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← Psychiatry / 4th Year / MBBS

OBSERVE / REASON / EXPLAIN

Capacity and consent

Explain decision-specific consent assessment.

Original teaching scenario / OSCE

Your practical station

A patient declines an offered assessment. Explain how you would support and assess the decision without making assumptions.

Recognise and interpret

Capacity is considered for the particular decision and time, using the applicable legal and clinical framework.

  • Support understanding
  • Explore the decision
  • Document and seek help
1

Support understanding

Explain relevant information in accessible language.

2

Explore the decision

Assess understanding and ability to consider information and communicate a choice.

3

Document and seek help

Record the assessment and obtain senior support when uncertain.

At the viva table

Try answering aloud, then open the suggested answer. Examiner questions vary.

01 / Does a psychiatric diagnosis automatically remove capacity?

No. Avoid diagnosis-based assumptions.

02 / Can capacity change?

Yes. It may vary with time and the decision.

03 / Why provide communication support?

A communication difficulty must not be mistaken for inability to decide.

04 / Is disagreement alone proof of incapacity?

No. A different choice does not by itself establish incapacity.

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