Legal, Ethical and Organizational Aspects (Professional Behaviours) — 54yo Man | Ethics | MCCQE1 Q#13588
MCCQE1 Question #13588
Dimension of Care
Health Promotion & Illness Prevention
Activity
Professional Behaviours
Objective
Legal, Ethical and Organizational Aspects
Section
Public Health / Ethics / Legal / Organizational (PHELO/PMCH)
Subject
Ethics
Last updated: February 2026
A 54-year-old man presents to the emergency department with crushing retrosternal chest pain and diaphoresis. ECG shows 3-mm ST elevation in leads II, III, and aVF. He is alert, oriented, and able to explain his condition and the consequences of refusing treatment. He states, “I understand I could die, and I still refuse any medications or procedures.”
His spouse arrives and identifies themself as the patient’s substitute decision-maker (SDM) and demands that the team proceed with thrombolysis and cardiac catheterization despite the patient’s refusal.
What is the most appropriate action by the physician?
Vital signs:
- T: 36.8 °C
- BP: 104/68 mmHg
- HR: 98 /min
- RR: 18 /min
- SpO2: 96% (RA)
Full answer analysis and choices are available inside the practice session.
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