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Proportionality in End-of-Life Ethics — SCE Palliative Medicine MCQ

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ModerateCommunication & EthicsProportionality in End-of-Life EthicsSCE Palliative Medicine

A palliative care team is discussing the ethical principle of proportionality in end-of-life care. What does proportionality mean in this context?

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Correct answer: CThe benefits of a treatment must outweigh its burdens — interventions should be proportionate to the realistic chance of benefit given the patient’s overall condition

Option C correctly captures the ethical principle of proportionality. It requires that an intervention’s benefits (such as symptom relief or life extension) realistically outweigh its burdens (including side effects, suffering, or decreased quality of life). NICE NG142 emphasizes reviewing treatments and stopping those that are no longer helpful, aligning with proportionality in practice. Option D ignores individual prognosis; B incorrectly limits proportionality to curative intent; C conflates cost with ethical judgment; and E inappropriately mandates maximum life extension regardless of burden.

Reference: NICE guideline NG142 (2019) emphasising stopping unhelpful treatments; and literature describing proportionality in palliative symptom control (Principles of symptom control in palliative medicine, 1998). https://www.nice.org.uk/guidance/ng142