Scenario Analysis: This scenario is professionally challenging because it requires the psychiatric-mental health nurse to navigate complex ethical considerations and evidence-based practice guidelines when faced with a patient whose personal beliefs may conflict with standard treatment protocols. Balancing patient autonomy with the nurse’s professional responsibility to provide evidence-based care, while adhering to the ethical principles of beneficence and non-maleficence, demands careful judgment. The nurse must also consider the potential impact of treatment decisions on the patient’s overall well-being and recovery trajectory within the framework of European psychiatric-mental health nursing standards. Correct Approach Analysis: The best professional practice involves a comprehensive, collaborative approach. This entails thoroughly reviewing the latest evidence synthesis regarding the efficacy and safety of the proposed treatment for the patient’s specific condition, considering both pharmacological and non-pharmacological interventions. Simultaneously, the nurse must engage in a detailed, empathetic discussion with the patient and their family (with consent) to understand the origins and depth of their beliefs, explore potential misunderstandings about the treatment, and collaboratively develop a shared decision-making pathway. This approach respects patient autonomy, upholds the principle of informed consent, and ensures that the chosen clinical pathway is both ethically sound and maximally beneficial, aligning with the principles of patient-centered care prevalent in European healthcare systems. Incorrect Approaches Analysis: One incorrect approach involves unilaterally dismissing the patient’s beliefs and proceeding with the standard treatment protocol without further exploration or discussion. This fails to respect patient autonomy and can lead to non-adherence, damaged therapeutic relationships, and potential ethical breaches related to informed consent. It overlooks the importance of understanding the patient’s perspective, which is crucial for effective care. Another incorrect approach is to abandon the evidence-based treatment entirely based solely on the patient’s stated beliefs, without attempting to find a compromise or explore alternative, evidence-supported interventions that might be more acceptable. This neglects the nurse’s professional duty to provide care that is supported by the best available evidence and could potentially lead to suboptimal patient outcomes or harm by withholding effective treatment. A third incorrect approach is to present the patient with a limited set of options that do not fully address the nuances of their concerns or the available evidence, thereby creating a false dichotomy. This can be perceived as manipulative and undermines the principle of genuine shared decision-making, failing to empower the patient in their treatment journey. Professional Reasoning: Professionals should employ a structured decision-making process that prioritizes patient-centered care, ethical principles, and evidence-based practice. This involves: 1) Thoroughly assessing the patient’s condition and the available evidence for treatment options. 2) Actively listening to and understanding the patient’s beliefs, values, and concerns. 3) Engaging in open and honest communication to explain treatment rationale, potential benefits, risks, and alternatives. 4) Collaboratively exploring treatment pathways that align with both evidence and patient preferences, seeking compromises where possible. 5) Documenting the decision-making process and the agreed-upon plan of care meticulously.

This scenario presents a professional challenge because psychiatric-mental health nurses often encounter individuals with complex histories and diverse educational backgrounds. Determining eligibility for licensure requires a meticulous evaluation of qualifications against established standards to ensure public safety and professional integrity. The Elite Pan-Europe Psychiatric-Mental Health Nursing Licensure Examination aims to standardize the competency of practitioners across participating European nations, necessitating a clear understanding of its purpose and the criteria for entry. The best approach involves a comprehensive review of the applicant’s educational transcripts, practical experience documentation, and any relevant professional certifications against the explicit eligibility requirements published by the Elite Pan-European Nursing Council. This method directly addresses the stated purpose of the examination, which is to verify that candidates possess the foundational knowledge and skills deemed essential for safe and effective psychiatric-mental health nursing practice within the European context. Adherence to these documented criteria ensures fairness, transparency, and upholds the regulatory framework governing nursing licensure across member states. An incorrect approach would be to rely solely on the applicant’s self-assessment of their skills and experience. This fails to meet the regulatory requirement for objective verification of qualifications and bypasses the established process for assessing competence. It introduces a significant risk of unqualified individuals entering the profession, potentially compromising patient care and undermining public trust. Another incorrect approach would be to prioritize the applicant’s years of practice in a non-European country without a formal assessment of how that experience aligns with the specific competencies and standards expected by the Elite Pan-European framework. While international experience can be valuable, it must be evaluated against the defined eligibility criteria to ensure it translates to the required European standards. This approach risks overlooking critical differences in training, scope of practice, and ethical considerations that are integral to the Pan-European licensure. A further incorrect approach would be to grant provisional eligibility based on a promise to complete further training after passing the examination. The purpose of the eligibility criteria is to ensure candidates are qualified *before* they undertake the licensure examination. Allowing individuals to proceed without meeting these prerequisites undermines the integrity of the examination process and the standards it seeks to uphold. Professionals should employ a decision-making framework that begins with a thorough understanding of the governing regulatory body’s published eligibility criteria. This involves systematically comparing the applicant’s submitted documentation against each requirement. When ambiguities arise, seeking clarification from the issuing authority or consulting official guidance documents is paramount. The ultimate goal is to ensure that all licensed practitioners meet the established standards for safe and competent practice, thereby protecting the public and maintaining the credibility of the profession.

This scenario presents a professional challenge due to the inherent complexity of assessing and monitoring mental health across diverse age groups, each with unique developmental, physiological, and psychosocial considerations. Ensuring accurate diagnosis and effective intervention requires a nuanced understanding of age-specific presentations of psychiatric conditions and the potential impact of co-occurring physical health issues. The nurse must navigate ethical obligations to provide individualized, evidence-based care while adhering to professional standards and regulatory frameworks governing psychiatric-mental health nursing practice within the European context. The most appropriate approach involves a comprehensive, lifespan-informed assessment that integrates biological, psychological, and social factors, utilizing validated assessment tools tailored to the individual’s developmental stage and presenting concerns. This approach prioritizes gathering detailed subjective and objective data, considering the client’s history, current symptoms, functional status, and environmental context. It aligns with the ethical imperative of beneficence and non-maleficence, ensuring that interventions are appropriate and minimize harm. Furthermore, it reflects the professional standards of practice that mandate thorough assessment as the foundation for diagnosis and ongoing monitoring, as outlined by relevant European nursing professional bodies and mental health guidelines which emphasize holistic and person-centered care. An approach that relies solely on a single diagnostic manual without considering individual variability or developmental context is ethically and professionally deficient. This failure to individualize care can lead to misdiagnosis and inappropriate treatment, violating the principle of non-maleficence. It also neglects the professional responsibility to conduct a thorough assessment that accounts for the unique presentation of symptoms across different age groups, potentially overlooking crucial developmental factors that influence mental health. Another less effective approach would be to focus exclusively on pharmacological interventions without a robust psychosocial assessment. This overlooks the complex interplay of biological, psychological, and social determinants of mental health and can lead to a superficial understanding of the client’s needs. It fails to meet the ethical standard of providing comprehensive care and may not address the root causes of distress, potentially leading to suboptimal outcomes and a violation of the principle of beneficence. Finally, an approach that prioritizes symptom reduction above all else, without considering the client’s functional capacity, quality of life, or long-term well-being, is also professionally inadequate. This narrow focus can lead to a reactive rather than proactive approach to care, failing to empower the individual and promote recovery. It neglects the ethical duty to promote the client’s overall welfare and may not align with the principles of recovery-oriented mental health care prevalent in European frameworks. Professionals should employ a systematic decision-making process that begins with a thorough understanding of the client’s presenting problem within their lifespan context. This involves active listening, critical thinking, and the application of evidence-based assessment frameworks. The process should then move to differential diagnosis, considering all plausible explanations, followed by the development of a collaborative, individualized care plan. Ongoing monitoring and evaluation are crucial, with adjustments made based on the client’s response and evolving needs, always guided by ethical principles and regulatory requirements.

The review process indicates a need to assess understanding of the Elite Pan-Europe Psychiatric-Mental Health Nursing Licensure Examination’s blueprint, scoring, and retake policies. This scenario is professionally challenging because it requires a nurse to navigate the official examination framework with integrity, ensuring fair assessment and adherence to established procedures. Misinterpreting or circumventing these policies can lead to invalid results, disciplinary action, and a compromised professional standing. Careful judgment is required to uphold the standards of the examination and the profession. The best approach involves a thorough and honest self-assessment of performance against the examination blueprint and understanding the official retake policy as outlined by the examination board. This means acknowledging areas of weakness identified during the examination and proactively seeking information on the specific conditions and limitations for retaking the exam, such as waiting periods or additional required training. This aligns with ethical principles of honesty and accountability in professional development and licensure. It respects the established regulatory framework designed to ensure competence and public safety. An incorrect approach would be to assume a passing score based on a subjective feeling of performance without consulting the official scoring criteria or to immediately seek a retake without understanding the prerequisites. This demonstrates a lack of diligence in adhering to the examination’s procedural requirements and could lead to premature or ineligible retake attempts. Ethically, it bypasses the structured assessment process. Another incorrect approach would be to attempt to influence the scoring or retake process through informal channels or by questioning the validity of the blueprint without a formal, documented basis. This undermines the integrity of the examination system and is professionally unethical, potentially leading to severe sanctions. It fails to respect the established governance of the licensure process. Finally, an incorrect approach would be to disregard the retake policy entirely and assume an immediate second attempt is possible, or to focus solely on the blueprint’s content without understanding how it translates to scoring and potential retake eligibility. This shows a superficial understanding of the examination’s structure and a failure to engage with the complete regulatory requirements for licensure. Professionals should approach licensure examinations with a commitment to understanding and adhering to all stated policies. This involves proactively reviewing examination blueprints, scoring methodologies, and retake regulations provided by the licensing body. When performance is uncertain, the professional decision-making process should prioritize seeking official clarification and following established procedures for assessment and remediation, rather than making assumptions or attempting to bypass the system.

Scenario Analysis: This scenario presents a common challenge for candidates preparing for a high-stakes licensure examination like the Elite Pan-Europe Psychiatric-Mental Health Nursing Licensure Examination. The difficulty lies in navigating the vast array of available preparation resources and determining the most effective and efficient timeline for study. Without a structured and evidence-informed approach, candidates risk wasting time on ineffective methods, experiencing burnout, or feeling inadequately prepared, which can have significant professional consequences for patient care and public safety. Careful judgment is required to balance comprehensive coverage with strategic resource utilization and realistic time management. Correct Approach Analysis: The best approach involves a systematic, multi-faceted preparation strategy that prioritizes official examination blueprints, reputable professional organizations’ guidelines, and evidence-based study techniques. This includes allocating dedicated time for reviewing core psychiatric-mental health nursing concepts, practicing with question banks that simulate exam difficulty and format, and engaging in collaborative study or seeking mentorship from experienced professionals. This approach is correct because it aligns with the principles of professional development and competency-based assessment. Regulatory frameworks and ethical codes for nursing licensure emphasize the importance of demonstrating a thorough understanding of the scope of practice and the ability to apply knowledge safely and effectively. Utilizing official examination content outlines ensures that study efforts are directly targeted at the knowledge and skills assessed, thereby fulfilling the implicit regulatory requirement to be competent. Engaging with professional organizations’ resources often reflects current best practices and ethical considerations within the field, further strengthening preparation. Incorrect Approaches Analysis: One incorrect approach involves relying solely on a single, popular study guide without cross-referencing with other materials or official guidance. This is professionally unacceptable because it limits exposure to diverse perspectives and potentially omits crucial information or nuances not covered by that specific guide. It fails to meet the ethical obligation to seek comprehensive knowledge and the regulatory expectation of broad competency. Another incorrect approach is to cram extensively in the final weeks before the examination, neglecting consistent study throughout the preparation period. This is professionally unsound as it promotes superficial learning and hinders long-term retention of complex information, which is vital for safe and effective psychiatric-mental health nursing practice. It contravenes the principle of continuous learning and professional growth expected of licensed practitioners. A further incorrect approach is to focus exclusively on memorizing facts and figures without engaging in critical thinking or application-based learning. This is ethically problematic as it does not prepare the candidate to apply knowledge in real-world clinical scenarios, which is the ultimate goal of licensure. It fails to demonstrate the higher-order cognitive skills necessary for sound clinical judgment and patient advocacy, as mandated by professional standards. Professional Reasoning: Professionals should approach licensure preparation with a mindset of continuous learning and evidence-based practice. This involves first understanding the examination’s scope and format through official documentation. Subsequently, they should identify reputable resources that align with these requirements, prioritizing those that promote critical thinking and application. A realistic timeline should be established, incorporating regular review, practice assessments, and opportunities for feedback. Professionals should also be prepared to adapt their study plan based on their progress and identified areas of weakness, seeking support from peers or mentors when needed. This systematic and self-directed approach ensures not only successful examination completion but also the development of a strong foundation for lifelong professional competence.

This scenario presents a professional challenge due to the inherent complexity of psychiatric-mental health conditions, the potential for rapid symptom fluctuation, and the ethical imperative to provide patient-centered care that is both safe and effective. The nurse must navigate the tension between established treatment protocols and the unique presentation of an individual patient, requiring a nuanced application of their knowledge. Careful judgment is essential to avoid diagnostic overshadowing, premature closure, or the imposition of personal biases. The most appropriate approach involves a comprehensive assessment that integrates the patient’s subjective experience with objective clinical findings, informed by an understanding of the underlying pathophysiology of their diagnosed condition. This approach prioritizes gathering detailed information about the onset, duration, severity, and impact of the current symptoms, while also considering potential contributing factors such as medication adherence, life stressors, and co-occurring conditions. By systematically evaluating these elements against the known pathophysiology of the patient’s primary diagnosis (e.g., schizophrenia, bipolar disorder, major depressive disorder), the nurse can formulate a differential diagnosis for the current presentation and identify the most likely cause of the observed changes. This allows for targeted interventions that address the root of the problem, rather than merely managing superficial symptoms. This aligns with the ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm), as well as professional standards that mandate evidence-based practice and individualized care planning. An approach that relies solely on the patient’s self-report without corroborating objective data or considering the pathophysiology of their known condition is professionally inadequate. This failure to integrate objective findings and pathophysiological understanding can lead to misdiagnosis or delayed appropriate treatment, potentially exacerbating the patient’s distress and hindering recovery. It neglects the nurse’s responsibility to critically evaluate information and apply their specialized knowledge. Another professionally unacceptable approach is to immediately assume that any new or worsening symptoms are solely a manifestation of the patient’s primary psychiatric diagnosis without a thorough differential assessment. While the primary diagnosis is a crucial consideration, it should not preclude the exploration of other potential causes, such as medical comorbidities, medication side effects, or substance use, which can mimic or exacerbate psychiatric symptoms. This can lead to a failure to identify and treat serious underlying medical issues, posing a significant risk to the patient’s health and safety. Furthermore, an approach that focuses exclusively on symptom management without understanding the underlying pathophysiological mechanisms is insufficient. While symptom relief is important, a deeper understanding of why symptoms are occurring allows for more effective and sustainable interventions. Without this pathophysiological grounding, interventions may be palliative rather than curative or restorative, limiting the patient’s potential for recovery and well-being. Professionals should employ a systematic decision-making framework that begins with a thorough assessment, including subjective and objective data. This is followed by a critical analysis of the findings in light of the patient’s known pathophysiology and differential diagnoses. Evidence-based guidelines and current research should inform the formulation of a care plan, which is then implemented and continuously evaluated for effectiveness. This iterative process ensures that care remains responsive to the patient’s evolving needs and is grounded in sound clinical reasoning and ethical practice.

This scenario presents a professional challenge due to the inherent conflict between a patient’s expressed wishes and the nurse’s professional judgment regarding their capacity to make informed decisions, particularly within the sensitive context of mental health care. The nurse must navigate complex ethical principles, including patient autonomy, beneficence, and non-maleficence, while adhering to strict professional standards and legal frameworks governing mental health practice in Europe. The core difficulty lies in accurately assessing the patient’s capacity, which is not a static state but can fluctuate, and in balancing the patient’s right to self-determination with the nurse’s duty of care. The best approach involves a comprehensive, multi-faceted assessment of the patient’s capacity to consent to treatment. This includes evaluating their ability to understand the information provided about their condition and proposed treatment, appreciate the consequences of their decisions, reason through the options, and communicate their choice. This approach is correct because it aligns with the fundamental ethical and legal principles underpinning psychiatric-mental health nursing across Europe, which emphasize respecting patient autonomy while ensuring their safety and well-being. Specifically, it adheres to guidelines that mandate thorough capacity assessments, often involving collaboration with the patient, their family (with consent), and other members of the multidisciplinary team. The process should be documented meticulously, reflecting the nurse’s professional responsibility and accountability. An approach that prioritizes immediate compliance with the patient’s stated refusal without a thorough capacity assessment is professionally unacceptable. This fails to uphold the principle of beneficence, as it may lead to the patient not receiving necessary treatment, potentially worsening their condition and causing harm. It also disregards the professional obligation to protect vulnerable individuals who may lack the capacity to make sound decisions due to their mental health state. Another unacceptable approach is to override the patient’s wishes solely based on a diagnosis of a mental health condition. This constitutes discrimination and violates the principle of autonomy. Capacity is assessed on an individual, decision-specific basis, not presumed based on a diagnosis. Professional standards require a nuanced evaluation rather than a blanket assumption of incapacity. Finally, an approach that relies solely on the opinion of a senior colleague without conducting an independent assessment is also professionally deficient. While consultation is valuable, the primary responsibility for assessing capacity and making professional judgments rests with the individual nurse. Delegating this critical function without personal engagement and evaluation undermines professional accountability and the patient’s right to an individualized assessment. Professionals should employ a structured decision-making process that begins with recognizing the potential for fluctuating capacity. This involves active listening, clear and accessible communication, and a systematic evaluation of the patient’s ability to understand, appreciate, reason, and communicate. Collaboration with the multidisciplinary team, including psychiatrists and psychologists, is crucial for a comprehensive assessment. Documentation should be thorough, detailing the assessment process, findings, and the rationale for any decisions made regarding the patient’s capacity and treatment plan. This ensures transparency, accountability, and adherence to ethical and legal standards.

This scenario presents a professional challenge due to the critical nature of medication management in psychiatric care, where patient vulnerability and the potential for adverse events are heightened. The nurse must balance therapeutic efficacy with patient safety, adhering to strict prescribing and administration protocols. Careful judgment is required to ensure that medication decisions are evidence-based, patient-centered, and compliant with European Union (EU) regulations governing medicinal products and patient rights. The best approach involves a comprehensive review of the patient’s current medication regimen, considering recent clinical assessments, potential drug interactions, and adherence patterns. This includes consulting the patient’s electronic health record for historical data and any documented allergies or adverse reactions. Furthermore, engaging in a direct, open conversation with the patient about their experiences with the current medication, including perceived benefits and side effects, is paramount. This collaborative discussion allows for shared decision-making, respecting the patient’s autonomy and promoting adherence. This approach is correct because it aligns with the principles of patient-centered care, pharmacovigilance, and the EU’s emphasis on informed consent and patient rights in healthcare. It also adheres to the general principles of good prescribing support, which necessitates a holistic understanding of the patient and their treatment. An incorrect approach would be to solely rely on the information provided by a family member without direct patient consultation. This fails to uphold the principle of patient autonomy and informed consent, as the patient’s own perspective and experience are disregarded. It also bypasses the nurse’s direct responsibility to assess the patient and their medication response. Another incorrect approach would be to adjust the medication dosage based on a single, uncorroborated report of a minor side effect without a thorough assessment or consideration of the medication’s therapeutic benefits and the patient’s overall clinical status. This could lead to unnecessary treatment disruption and potentially compromise the patient’s mental health stability. It neglects the systematic evaluation required for safe medication management. A further incorrect approach would be to immediately discontinue the medication without consulting the prescribing physician or exploring alternative management strategies. This bypasses established protocols for medication changes in psychiatric care and could lead to withdrawal symptoms or relapse, jeopardizing patient safety and therapeutic outcomes. The professional reasoning process for similar situations should involve a systematic approach: first, gather comprehensive patient data (clinical, historical, and experiential); second, assess the patient’s current condition and medication response; third, consult relevant guidelines and prescribing information; fourth, engage in shared decision-making with the patient; and fifth, collaborate with the prescribing physician for any necessary medication adjustments, always prioritizing patient safety and well-being within the regulatory framework.

Scenario Analysis: This scenario presents a professional challenge due to the inherent tension between a patient’s expressed wishes and the clinician’s professional judgment regarding their capacity to make informed decisions. Navigating this requires a delicate balance of respecting autonomy while ensuring patient safety and well-being, all within the framework of European psychiatric-mental health nursing standards and relevant national legislation. The complexity arises from the potential for misinterpretation of the patient’s statements, the subjective nature of assessing capacity, and the ethical imperative to act in the patient’s best interest without unduly infringing on their rights. Correct Approach Analysis: The best professional practice involves a systematic and documented assessment of the patient’s capacity to consent to or refuse treatment. This approach prioritizes understanding the patient’s current mental state, their ability to comprehend the information provided about their condition and treatment options (including risks and benefits), and their capacity to weigh this information and communicate a clear decision. This aligns with the ethical principles of autonomy and beneficence, as well as the legal requirements in many European jurisdictions that mandate capacity assessment before proceeding with or withholding treatment against a patient’s expressed wishes. It ensures that decisions are patient-centered and legally sound. Incorrect Approaches Analysis: One incorrect approach involves immediately overriding the patient’s refusal based on the clinician’s belief that the refusal is a manifestation of their illness. This fails to acknowledge the patient’s right to self-determination and bypasses the crucial step of assessing capacity. It assumes that any refusal by a patient with a mental health condition is automatically invalid, which is a violation of ethical principles and potentially legal statutes. Another incorrect approach is to accept the patient’s refusal without further investigation, solely based on their verbal statement. This neglects the professional responsibility to ensure the patient has understood the implications of their decision and is not acting under a delusion or severe cognitive impairment that compromises their capacity. It risks patient harm if the refusal leads to a deterioration of their condition. A third incorrect approach is to involve family members in making the decision without first establishing the patient’s lack of capacity. While family can be a source of support and information, the primary decision-making authority rests with the patient if they possess capacity. Involving family prematurely can undermine the patient’s autonomy and create unnecessary conflict. Professional Reasoning: Professionals should employ a decision-making framework that begins with a presumption of capacity. When a patient expresses a refusal of treatment, the professional’s immediate action should be to initiate a formal capacity assessment. This assessment should be conducted by a qualified professional, involve clear communication with the patient, and be thoroughly documented. If capacity is found to be lacking, then and only then should alternative decision-making pathways, such as involving a designated substitute decision-maker or seeking legal guidance, be explored. Throughout this process, maintaining open communication with the patient, even if they are deemed to lack capacity, is essential.

This scenario presents a professional challenge due to the inherent conflict between a patient’s expressed wishes and the clinician’s assessment of their capacity to make informed decisions, particularly in the context of mental health. The nurse must navigate complex ethical principles, including patient autonomy, beneficence, and non-maleficence, while adhering to stringent European Union (EU) regulations concerning patient rights and mental health care. The need for a nuanced, evidence-based approach is paramount to ensure patient well-being and legal compliance. The best approach involves a comprehensive, multi-faceted assessment of the patient’s capacity to consent. This includes evaluating their understanding of the proposed treatment, its benefits, risks, and alternatives, as well as their ability to retain and weigh this information to arrive at a decision. This approach is correct because it directly aligns with the principles enshrined in the EU Charter of Rights, which emphasizes human dignity and the right to integrity, and the General Data Protection Regulation (GDPR) regarding informed consent for processing personal health data. Furthermore, it adheres to the ethical guidelines of professional nursing bodies across Europe, which mandate that consent must be voluntary, informed, and given by an individual with the requisite mental capacity. This process ensures that any decision made is respected and legally sound, prioritizing the patient’s rights while safeguarding their welfare. An incorrect approach would be to proceed with the treatment solely based on the patient’s initial verbal agreement without a thorough capacity assessment. This fails to acknowledge that a patient’s initial consent may not be truly informed or enduring, especially if their mental state fluctuates. Ethically, this breaches the principle of beneficence by potentially exposing the patient to harm without ensuring they fully comprehend the implications. Legally, it contravenes EU directives on patient rights in healthcare, which require demonstrable informed consent. Another incorrect approach would be to override the patient’s wishes and proceed with treatment based on the assumption that their family knows best. While family involvement is often valuable, it cannot substitute for a direct assessment of the patient’s capacity and their own autonomous decision-making. This approach disregards the fundamental right to self-determination and can lead to legal challenges and ethical breaches, as it prioritizes external opinions over the patient’s own expressed will and rights. A further incorrect approach would be to delay treatment indefinitely due to uncertainty about the patient’s capacity, without actively seeking to clarify or support their decision-making process. While caution is necessary, prolonged inaction can be detrimental to the patient’s mental health and recovery, potentially violating the principle of beneficence by withholding necessary care. This approach fails to engage in the proactive assessment and support required to facilitate informed consent or to establish appropriate legal or ethical pathways for care when capacity is genuinely lacking. Professionals should employ a decision-making process that begins with a presumption of capacity. If doubts arise, a structured, documented capacity assessment should be conducted, involving relevant professionals and, where appropriate, the patient’s designated representative or advocate. This assessment should be iterative, allowing for re-evaluation as the patient’s condition changes. Transparency with the patient and their family about the assessment process and its outcomes is crucial. When capacity is found to be lacking, the decision-making process must then shift to identifying the least restrictive means of providing necessary care, always in accordance with applicable EU and national legislation and ethical codes.