Ethical Considerations Surrounding Patient Refusal of Emergent Aortic Surgery

Stanford type A (DeBakey type I and II) acute aortic dissections are medical emergencies that almost always require surgical intervention. Patients who develop an aortic dissection experience a high mortality rate when untreated, which emphasizes the need to identify and treat the condition quickly. We present a case where patient refusal in the setting of questionable capacity delayed definitive treatment and discuss considerations and approaches to assessing capacity in the emergent setting.