A patient with schizophrenia on your ward wants to leave against medical advice. The team is concerned about their safety. How do you assess their capacity to make this decision?

Tips to guide your answer

- Capacity is decision-specific and time-specific - not a global assessment

- The five MCA principles: (1) presumption of capacity, (2) supported decision-making, (3) unwise decisions do not indicate incapacity, (4) best interests, (5) least restrictive option

- Two-stage test: Stage 1 - is there an impairment of or disturbance in the functioning of the mind or brain? Stage 2 - does this impairment mean the person cannot make the specific decision?

- Stage 2 criteria: understand, retain, use or weigh, communicate the decision

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How to approach this Psychiatry interview question

This ethics question is common in Psychiatry NHS interviews because it reveals how you think under interview pressure, not just what facts you can recall. Use "A patient with schizophrenia on your ward wants to leave against medical advice. The..." 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 psychiatry, risk assessment, capacity, legislation, rapport, and multidisciplinary planning are usually central. Keep the answer humane, structured, and legally aware.

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.

Capacity is decision-specific and time-specific - not a global assessment
The five MCA principles: (1) presumption of capacity, (2) supported decision-making, (3) unwise decisions do not indicate incapacity, (4) best interests, (5) least restrictive option
Two-stage test: Stage 1 - is there an impairment of or disturbance in the functioning of the mind or brain? Stage 2 - does this impairment mean the person cannot make the specific decision?