Ms. C is a 22-year-old woman with unstable insulin-dependent diabetes who has suffered an intrauterine death at 36 weeks of gestation. She is refusing medical induction of labor, which has been recommended to avoid the risk of potentially life-threatening sepsis. She insists that the birth must be “natural” and becomes extremely distressed when attempts are made to discuss this further. In the past, she has had repeated admissions to hospital as a result of poor diabetic control and, consequently, is well known to staff. Although the current clinical state is stable, the medical team have become extremely anxious about the possible consequences of her refusal of treatment and they have requested an assessment of capacity. Ms. C refuses to discuss her decision and turns her back to the interviewer. A further attempt to discuss this is met with a similar response.