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Exploring Disengagement from Follow-Up — SCE Palliative Medicine MCQ

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ModerateCommunication & EthicsExploring Disengagement from Follow-UpSCE Palliative Medicine

A 68‑year‑old man with advanced lung cancer tells the palliative care team that he has decided to stop attending follow‑up appointments because “what’s the point?” His family are upset. What is the most appropriate clinical response?

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Correct answer: E — Explore his reasoning sensitively—this may represent realistic acceptance

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

Option D is correct. UK‑based GMC guidance and NICE shared decision‑making standards require clinicians to engage patients in meaningful dialogue—understand their values, reasons and feelings—before accepting disengagement, especially in palliative settings. This approach permits identification of depression, unmet concerns or acceptance, and supports respect for autonomy with appropriate safeguarding. Options A, B and C violate professional and ethical standards by being punitive, coercive or overriding autonomy. Option E closes off exploration and may miss treatable issues or misalignment with patient values.

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