Capacity and consent station
PLAB pack: ethics OSCE
Theory
Theory 1: Station focus
Capacity and consent tests decision-specific assessment, information, voluntariness and best interests.
- Can the patient understand and retain information?
- Can they weigh options and communicate a decision?
- Is there coercion or fluctuating capacity?
Theory 2: Reasoning path
Capacity is time-specific and decision-specific; refusal alone does not prove incapacity.
- Identify the immediate risk.
- Choose the safest first action.
- Explain why the distractors are weaker.
Theory 3: Expected output
The candidate should assess capacity steps and explain consent clearly.
- Explain decision and options.
- Assess understand/retain/weigh/communicate.
- Document conclusion and plan.
Vocabulary and model dialogue
Doctor: Can you tell me what you understand about the procedure and its risks?
Patient: I understand the risk, but I do not want it today.
Doctor: I need to check that you can weigh the options and make this decision freely.
Practice
Practice 1: Stem analysis
A patient refuses a procedure, and the team asks whether they have capacity.
Output: Age, timing, symptoms, vital risk and one missing question.Practice 2: First action
Choose the first safe action: Assess decision-specific capacity using the four abilities.
Output: One action plus clinical reason.Practice 3: Differential
Compare Decision-specific capacity assessment with two alternatives.
Output: Three-line differential table.Practice 4: Exam response
Write a capacity assessment checklist and consent explanation.
Output: Checklist + explanation.Interactive tasks
Interactive 1: Red-flag sort
Sort findings from "Capacity and consent station" into urgent and non-urgent details.
Interactive 2: Distractor removal
Remove the least plausible option from: Assume incapacity because of refusal, Proceed without discussion, Ask family to decide automatically.
Interactive 3: Timed response
Give a 90-second exam answer using the station output steps.
Quiz
Capacity must be assessed for this decision using the four abilities.
The safest answer addresses the immediate clinical risk first.
Exam documentation must record the detail that changes management.
Safe exams include patient understanding and escalation advice.
The station expects a short, defensible clinical chain.