AKT-5156

AKT-5156

A 55-year-old man comes to see you along with a support worker. He has a background of Down syndrome and cardiac surgery as a child. He sometimes struggles to communicate with others but can do this with help from his support worker.
He has been having rectal bleeding, abdominal pain, and looser stools for four months. He has a normal abdominal examination but refuses a per rectum (PR) examination.
You want to make an urgent 2-week-wait referral for a colonoscopy, but he says that he doesn’t want any more tests.
You explain that the test is for cancer, from which he could die if not treated. After discussing this for some time, he tells you that he doesn’t want to have any tests done at all, even if this meant he were to die.
What would be the most appropriate action?