Which action is required if a patient who is not oriented cannot participate in decision-making during refusal?

• A. Transport the patient or involve a surrogate
• B. Ignore orientation and proceed
• C. Obtain a signature from a non-qualified person
• D. Cancel the call

Answer: (A)

When a patient is not oriented and cannot participate in decision-making, they lack capacity for that decision. The appropriate step is to involve a surrogate decision-maker or transport the patient so capacity can be assessed and proper consent obtained. A surrogate, such as a legally authorized representative or a family member who knows the patient’s values, can make or support the decision on the patient’s behalf, ensuring the patient’s wishes or best interests are respected. Ignoring orientation and proceeding would violate the patient’s lack of capacity; obtaining a signature from someone not legally authorized isn’t valid; cancelling the call would prevent necessary assessment and care.