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Withholding vs Withdrawing Ethical Equivalence — SCE Palliative Medicine MCQ

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HardCommunication & EthicsWithholding vs Withdrawing Ethical EquivalenceSCE Palliative Medicine

A palliative care trainee reports feeling more uncomfortable withdrawing a treatment already in place than deciding not to start it in the first place. What do current UK ethical and legal frameworks indicate regarding this distinction?

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

Reveal the answer and explanation

Correct answer: A — Ethically and legally as the preferred next management strategy in this patient

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

UK professional guidance (RCPCH framework, Department of Health consent guidance) affirms that withholding and withdrawing life‑sustaining treatment are ethically and legally equivalent when clinical context is identical. Any discomfort trainees feel withdrawing treatment stems from psychological biases such as status quo bias or withdrawal aversion, but this should not influence clinical decisions. Distractors: A is wrong—there is a clear ethical framework; B is incorrect—no ethical or legal hierarchy exists; C is false—both are permitted when in patient's best interests; E is incorrect—responsibility does not legally differ by grade.

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