Consent and capacity

Global core

A capable adult accepts or refuses treatment. Capacity is decision-specific and can change. In an emergency, immediately necessary treatment may be given when the person cannot consent, unless a valid and applicable refusal is already known. Who assesses capacity, and which statute applies, is local law. Training in one country does not transfer that legal authority to another.

What stays the same

• Capacity is decision-specific: understand, retain, weigh, and communicate.
• A capable adult may refuse, including when the family disagrees.
• Emergency treatment without consent is for the person who cannot decide, unless a valid refusal is already known.

1. Recognize. A decision is needed, and the person may be too ill, confused, or coerced to make it.
2. Reason. Can they understand, retain, weigh, and communicate this decision?
3. Prioritize. An immediate threat to life, if no valid refusal is known.
4. Act safely. If they have capacity, follow their decision. If they do not, use the legal route of that place. Do not borrow another country's form.

Local adaptation

• United Kingdom

  In England and Wales the Mental Capacity Act 2005 is the statute for adults who may lack capacity. It is not a United States federal statute, and it does not by itself authorize practice or consent rules outside its jurisdiction. Emergency treatment when consent cannot be obtained is addressed in UK professional guidance and is subject to a valid advance refusal where one applies.

  UK Parliament. Mental Capacity Act 2005 (2005). Accessed 2026-09-29.

Exam lens

Who can consent, and what an emergency allows.