A 65-year-old man with moderate dementia is admitted electively for hip surgery. He does not understand what the surgery involves and cannot retain the explanation. Which of the following correctly describes his legal situation regarding consent?

• A Consent is not required if two doctors agree treatment is needed
• B His wife can routinely consent on his behalf under standard next-of-kin rules
• C He lacks capacity; a legal guardian or designated nominated representative may give consent under MHCA 2017 ✓
• D The surgeon proceeds under emergency doctrine as no consent can be obtained

Explanation

Assessment of capacity is decision-specific and requires: understanding information, retaining it, weighing it, and communicating a decision. This patient lacks capacity for this specific decision. Under the MHCA 2017, persons with mental illness (including dementia) may designate a Nominated Representative (NR) in an Advance Directive. If no Advance Directive exists, a legal guardian or the NR (typically family) can provide substitute consent. India does not have a unified Mental Capacity Act; the Courts may need to be involved for major elective decisions in incapacitated adults without a nominated representative.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.