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Post-call brain cannot wrap my head around medical ethics, capacity assessment, and surrogate hierarchy today

Idk why my brain refuses to hold onto medical ethics, capacity assessment, and surrogate hierarchy. Every time I review my missed qs, I see it was decision-making capacity is clinical (determined by treating physician, not psychiatry/court) and task-specific or surrogate priority when no advance directive/healthcare proxy exists: spouse -> adult children -> parents -> adult siblings, and I tell myself I wont miss it again, then 3 days later I do the exact same thing.

Especially when the stem sets up consulting hospital ethics or court before honoring a valid living will just bc one distant relative disagrees. What helped this click for you guys?

Context: currently while doing rapid review flashcards trying to connect pathophys to mgmt.

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Honestly the trick that saved me on medical ethics, capacity assessment, and surrogate hierarchy while doing rapid review flashcards was focusing 100% on treating life-threatening emergencies under implied consent without waiting for family if patient lacks capacity. Dont try to memorize a massive table while you are tired trying to connect pathophys to mgmt.

Instead, split the stem into two quick checks: (1) is decision-making capacity is clinical (determined by treating physician, not psychiatry/court) and task-specific present, and (2) how does surrogate priority when no advance directive/healthcare proxy exists: spouse -> adult children -> parents -> adult siblings change the next step? 90% of the time people miss this bc of consulting hospital ethics or court before honoring a valid living will just bc one distant relative disagrees. Write a 1-line contrast note on an index card and read it before your morning block tomorrow, it clicks super fast.

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Adding onto what was said above: for medical ethics, capacity assessment, and surrogate hierarchy, if you ever get stuck b/w two choices while doing rapid review flashcards trying to connect pathophys to mgmt, go back to treating life-threatening emergencies under implied consent without waiting for family if patient lacks capacity and pick the option that addresses decision-making capacity is clinical (determined by treating physician, not psychiatry/court) and task-specific directly.

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One extra clinical pearl for medical ethics, capacity assessment, and surrogate hierarchy: whenever they mention surrogate priority when no advance directive/healthcare proxy exists: spouse -> adult children -> parents -> adult siblings while doing rapid review flashcards, always double check the vitals and timeline bc consulting hospital ethics or court before honoring a valid living will just bc one distant relative disagrees is their favorite way to trick people trying to connect pathophys to mgmt.

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What helped me lock in medical ethics, capacity assessment, and surrogate hierarchy while doing rapid review flashcards trying to connect pathophys to mgmt was making just 2 quick contrast cards comparing decision-making capacity is clinical (determined by treating physician, not psychiatry/court) and task-specific vs surrogate priority when no advance directive/healthcare proxy exists: spouse -> adult children -> parents -> adult siblings instead of re-reading the whole chapter.

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