AbstractComplex ethical considerations arise when providing medical care for unrepresented patients. Additionally, case reports on navigating ethical challenges when caring for unrepresented patients are sparse. Here we report a clinical case of a patient who has intellectual disability, is unrepresented, and has aortic valve stenosis. We demonstrate a detailed application of capacity assessments, as well as the standards of proxy consent. We also pose a successful implementation of two-physician consent as an effective procedure to help navigate medical care for unrepresented patients. Finally, we discuss the need to streamline the provision of medical care for unrepresented patients. Through this case report, we aim to contribute to the ongoing discussion of how to best provide medical care for unrepresented patients.