The patient is choosing to leave against medical advice after the medical team has attempted to convince them to stay and continue the medical work-up/treatment by explaining their possible diagnoses and treatment options.  They understand that leaving without a complete workup could result in death, permanent disability, or a missed diagnosis. They verbalized understanding of possible diagnosis and treatment with no apparent barriers to learning identified. In my opinion, they have clinical capacity. I have encouraged them to return at their earliest convenience to an emergency room, their primary doctor, or any medical treatment facility to resume care. They understand that the emergency room is open 24 hours a day.  I cannot identify any social stressors that I could personally alleviate to help the patient make the correct decision to stay in the emergency department.