A woman in advanced labour with a pathological CTG is screaming and saying she does not want any intervention. Does she have capacity to refuse a caesarean section?

Tips to guide your answer

- Mental Capacity Act 2005: a person has capacity if they can (1) understand the information, (2) retain it, (3) weigh it up to make a decision, (4) communicate their decision

- Presumption of capacity: every adult is presumed to have capacity unless demonstrated otherwise

- Pain, distress, exhaustion, and fear in labour do NOT automatically mean the woman lacks capacity - but they can impair it

- Address factors that may be impairing capacity: offer adequate pain relief, create a calm environment, give clear and simple information

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How to approach this Obstetrics & Gynaecology interview question

This ethics question is common in Obstetrics & Gynaecology NHS interviews because it reveals how you think under interview pressure, not just what facts you can recall. Use "A woman in advanced labour with a pathological CTG is screaming and saying she does not..." as the anchor for a concise answer with a clear opening, a clinical or professional structure, and a reflective close.

What the panel is testing

A strong ethics answer makes the competing duties visible. Name the principle or legal issue, then describe the practical steps you would take in the hospital: gather facts, assess capacity where relevant, seek advice, document, and protect the patient. For obstetrics and gynaecology, show that you can balance urgency, consent, escalation, and multidisciplinary working. Labour ward, theatre, safeguarding, and communication with women and families may all be relevant.

Identify the ethical tension before jumping to a decision: capacity, consent, confidentiality, best interests, or law.
Use local policy and senior advice, and be explicit about safeguarding or immediate patient-safety concerns.
Balance respect for autonomy with professional duties, documentation, and clear communication.

How to structure your answer

For a ethics prompt, aim for a short opening sentence, then two or three evidence-led points, then a final reflection. If you use STAR, keep the result and reflection as strong as the situation. If it is a clinical scenario, say what you would do now, what you would do next, and how you would keep the patient safe while help is coming.

Open by naming the main issue in the question.
Give a structured response rather than a memorised script.
End with escalation, documentation, learning, or follow-up.

Common mistakes to avoid

The weakest answers usually stay too vague, ignore the specific role, or miss the safety issue hidden in the question. Do not use this page to memorise a perfect paragraph. Use it to rehearse the shape of a safe answer, then adapt it to your own experience and the post you are applying for.

Mental Capacity Act 2005: a person has capacity if they can (1) understand the information, (2) retain it, (3) weigh it up to make a decision, (4) communicate their decision
Presumption of capacity: every adult is presumed to have capacity unless demonstrated otherwise
Pain, distress, exhaustion, and fear in labour do NOT automatically mean the woman lacks capacity - but they can impair it