A 34-year-old man with trisomy 21 is brought to the Emergency Department because of a...

Patients with developmental disabilities must still be engaged directly unless clearly incapable. It is vital to first establish the companion’s relationship to the patient and give the patient the opportunity to communicate.

Toronto Notes 2023 – ELOM, Consent and Capacity:

“Presume capacity in adults with developmental disabilities unless proven otherwise. Direct communication with the patient is essential, and the identity of accompanying individuals should be clarified.”

MCCQE1 Objectives – ELOM > Patient Autonomy and Consent:

“Candidates must respect patient autonomy and include developmentally delayed individuals in medical discussions unless incapacity is determined.”

Options A and C delay establishing capacity and relationship. Option D is premature. Option E bypasses consent and interaction with the patient.