QuestionSBA
QuestionChoice
This is correct. The Mental Health Act cannot be used to treat physical health symptoms apart from a few exceptions including severe anorexia nervosa. The patient's capacity needs to be assessed to refuse this treatment and if present, even if this decision were to be deemed unwise, is his to make. If absent, action should be taken to treat him in his best interests.
10034972
a
Assess his capacity to refuse treatment
QuestionChoice
His capacity needs to be established first before considering best interests discussions including the opinions of any appointed attornies, least restrictive options, what the patient wants now and what they wanted in the past.
10034975
d
Obtain consent from a family member to treat his infective endocarditis
QuestionChoice
This may well be the course of action if the patient is found to have capacity with regards to deciding to accept/reject treatment for infective endocarditis but given that it is potentially unwise, a capacity assessment should be performed.
10034976
e
Do not treat his infective endocarditis as he has refused
QuestionChoice
Physical health symptoms are generally not treated under the Mental Health Act.
10034973
b
Treat his infective endocarditis under the Mental Health Act
QuestionChoice
His capacity needs to be established first. If the patient lacks capacity, a best interests decision can be made.
10034974
c
Treat his infective endocarditis as it is in his best interests
Concept
Chapter
2693
4142
Key principles of MCA (Mental Capacity Act)
Topic
184
Ethics and Law
19398
Assessing capacity to refuse treatment involves evaluating the person's ability to understand the situation, weigh the benefits and risks, communicate a decision, and make a choice based on rational reasoning.
A 26-year-old man is an inpatient in the psychiatry ward under Section 2 due to a manic relapse of bipolar disorder. Whilst on the ward, he develops a fever and a new pan-systolic murmur can be heard. He refuses treatment for infective endocarditis despite being informed of its sequelae.

What is the most appropriate next step?
a