Afghanistan Comprehensive Specialization Exam

Practice session

A 68-year-old male with mild early-stage vascular dementia and chronic critical limb ischemia is advised to undergo an urgent femoral-popliteal bypass to prevent above-knee amputation. His daughter insists that because he has a diagnosis of dementia, he is legally incompetent and she must make all medical decisions for him. The patient expresses a clear preference to proceed with the surgery after a physician discussion. According to medical jurisprudence and bioethics, what are the four fundamental legal/clinical standards required to demonstrate medical decision-making capacity, and who determines clinical capacity?

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