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Off-Label Prescribing in Palliative Care — SCE Palliative Medicine MCQ

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EasyCommunication & EthicsOff-Label Prescribing in Palliative CareSCE Palliative Medicine

A palliative care registrar is asked whether she can prescribe unlicensed (‘off‑label’) medications in the hospice. Many palliative care drugs are used off‑label. What is the legal and professional position?

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Correct answer: A — Prescribing unlicensed or off‑label medications is legally permissible and frequently practised in palliative care

Option A is correct. UK law and professional guidance (MHRA, GMC via SPS summary) allow prescribers—including registrars—to prescribe off‑label or unlicensed medicines when clinically justified. The prescriber assumes full professional and legal responsibility, must be supported by evidence or accepted practice, inform the patient appropriately, and clearly document the rationale. Option D is incorrect: prescribing is not restricted to consultants. Option E is wrong: written consent for each dose is unnecessary; informed consent is required but not per dose. Option C is false: NICE approval is not a legal requirement for off‑label prescribing. Option B is incorrect: off‑label prescribing is legal within proper governance.

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