During holds, if the person lacks capacity, how should treatment decisions be made?

• A. Not at all; waiting for consent.
• B. Under statutory authority for involuntary care.
• C. Based on the patient’s expressed wishes only.
• D. By the county health department only.

Answer: (B)

When someone is on a hold and cannot make valid medical decisions, treatment is guided by statutory authority for involuntary care. In California, an emergency hold (5150) allows clinicians to evaluate and provide necessary treatment up to 72 hours when the person is a danger to themselves or others or gravely disabled. In this situation, decisions about treatment are made by the treating professionals under the welfare and institutions code, not by the person’s own consent. The patient’s expressed wishes aren’t controlling when capacity is lacking, and the county health department isn’t the sole decision-maker. The focus is on providing safe, appropriate care under the involuntary treatment framework.