Table 1.

Treatment refusal in cases of dementia

Refusal	Challenging issue
Minor intervention with a low or unclear risk involved where the patient has no living relatives or legal representatives.	Mild forgetfulness: Information about the intervention is lost after each appointment, but the attention and awareness are preserved so that momentary informed consent is possible.
Intervention for major, but non-life-threatening disease.	Severe cognitive deficits, but earlier oral statements consistent with the refusal.
Life-saving surgery (e.g., necessary amputation) and the patient has no living relatives or next of kin.	Patient lacks capacity according to the psychiatric consultant, but to neglect the refusal would mean to heavily infringe on the patient’s actual expressed will.