To meet criteria of capacity to refuse medical care, which condition must be documented?

• A. The patient must be intoxicated.
• B. The patient must be stable and cannot have hypoxia, elevated BAL, or be under the influence.
• C. The patient must have no history of mental illness.
• D. The patient must physically sign a document.

Answer: (B)

Capacity to refuse medical care depends on the patient’s ability to understand information, appreciate the consequences, reason about options, and communicate a choice at the time the decision is made. Any factors that impair those abilities—such as hypoxia or intoxication—undermine capacity. Therefore, documenting that the patient is stable and not experiencing hypoxia, not intoxicated, and not under the influence provides evidence that there are no impairing factors affecting decision-making at that moment.

The other points don’t establish capacity. Having no history of mental illness isn’t required—patients with mental illness can still have the capacity to refuse if they understand and decide. Signing a document isn’t what confers capacity; capacity is about the current cognitive ability to decide, not the act of signing a form.