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Recognising Psychological Abuse in Palliative Care — SCE Palliative Medicine MCQ

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HardCommunication & EthicsRecognising Psychological Abuse in Palliative CareSCE Palliative Medicine

During a home visit a capacitous patient appears frightened when his partner answers for him and controls access to medication. There is no immediate physical injury. What is the most proportionate first response?

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Correct answer: E — Private patient interview followed by safeguarding-risk assessment

Creating a safe private opportunity to hear the patient is the proportionate first response. Coercive, intimidating or controlling behaviour can be psychological abuse, even in the absence of physical injury. The clinician assesses immediate risk and desired outcomes, records objective observations and discusses safeguarding escalation through local procedures. Public confrontation may increase danger; involuntary removal before assessment can override liberty; and safeguarding should remain person-led unless serious risk justifies proportionate information sharing.

Reference: Care and support statutory guidance: safeguarding: https://www.gov.uk/government/publications/care-act-statutory-guidance/care-and-support-statutory-guidance