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Reversing the Dying Diagnosis — SCE Palliative Medicine MCQ

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ModerateEnd of Life CareReversing the Dying DiagnosisSCE Palliative Medicine

A palliative care consultant reviews a patient who has been designated as "dying" for 5 days but has stabilised. She continues to take sips of fluid and is semi-conscious. Some medications were stopped when dying was diagnosed. What should happen now?

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

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Correct answer: A — Reassess — if clinical features no longer suggest imminent death

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

This patient’s clinical stabilization—continued oral intake and semi-conscious state after 5 days—indicates that the diagnosis of imminent dying may no longer apply. NICE NG31 explicitly states that improvement in signs or symptoms may indicate stabilising or recovery and mandates regular (at least daily) reassessment with updating of the care plan. Moreover, the full guideline acknowledges that recovery signs (e.g., alertness, oral intake) may warrant reinstatement of previously withdrawn medications and supportive measures. Options A, B, D, and E ignore the need for dynamic reassessment and individualized planning.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer/palliative-care