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Honest Reassurance About Dying Pain — SCE Palliative Medicine MCQ

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ModerateCommunication & EthicsHonest Reassurance About Dying PainSCE Palliative Medicine

A 45-year-old woman with advanced cancer asks her palliative care consultant to promise that she will not be in pain when she dies. What is the most honest and compassionate response?

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

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Correct answer: B — I cannot promise zero pain as the preferred next step

Option B is correct because it balances honesty—acknowledging that zero pain cannot be guaranteed—with compassion and commitment to effective symptom control and presence. NICE NG31 emphasises that not all dying patients have pain but that it should be identified and managed promptly and effectively. Honest communication that includes uncertainty and active care planning is encouraged. Distractors: B (avoidance) breaches duty to communicate; C and D (false promises or sedation guarantees) risk loss of trust and may cause harm; E (inevitability nihilism) contradicts guideline-based optimism about symptom control.

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