What should be done when a patient lacks decision-making capacity?

• A. Force treatment.
• B. Obtain consent from a legally authorized representative or surrogate decision-maker.
• C. Do nothing.
• D. Wait for patient to regain capacity before acting.

Answer: (B)

When a patient cannot understand information or communicate a choice, decisions about treatment should be made by someone else who is legally authorized to decide for them. A legally authorized representative or surrogate gathers the necessary information, explains options, and consents on the patient’s behalf. The surrogate should follow the patient’s known wishes and values (substituted judgment) if they’re known, or act in the patient’s best interests if they aren’t. This approach respects the patient’s autonomy by ensuring care aligns with their preferences even when they can’t voice a decision.

Forcing treatment without consent isn’t appropriate, except in true emergencies where delaying care would cause serious harm and no surrogate is available. Waiting for the patient to regain capacity or doing nothing would fail to meet ethical and legal standards and could lead to harm or inappropriate inaction.