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Advance Statement vs Advance Decision — SCE Palliative Medicine MCQ

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HardEnd of Life CareAdvance Statement vs Advance DecisionSCE Palliative Medicine

A capacitous patient wants a future refusal of invasive ventilation to remain binding even if death results. Which additional formalities distinguish this ADRT from an advance statement?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Written, signed, witnessed, treatment-specific, and expressly applicable despite life risk

Explanation lettering: D = shown as A · A = shown as B · B = shown as C · E = shown as D · C = shown as E

A is correct. A refusal of life-sustaining treatment must be written, signed and witnessed and expressly state that it applies even if life is at risk; it must also be valid and applicable to the circumstances. B and D are advance preferences, not a binding treatment refusal. C cannot replace the capacitous donor’s decision, and E gives relatives no authority to create an ADRT.

Reference: NHS: advance statement about care wishes: https://www.nhs.uk/tests-and-treatments/end-of-life-care/planning-ahead/advance-statement/ NHS: advance decision to refuse treatment: https://www.nhs.uk/tests-and-treatments/end-of-life-care/planning-ahead/advance-decision-to-refuse-treatment/