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Proactive NIV Withdrawal Discussion — SCE Palliative Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardNon-Malignant Palliative CareProactive NIV Withdrawal DiscussionSCE Palliative Medicine

A capacitous patient with motor neurone disease now uses NIV 20 hours daily and communicates reliably by eye-gaze. He has not asked about withdrawal. What should the specialist team do?

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

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Correct answer: C — Offer discussion now about future NIV use, symptom control and possible withdrawal

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

D is correct. NICE recommends opportunities to discuss end-of-life preferences at diagnosis and key respiratory or intervention points, with earlier discussion if communication or capacity may deteriorate. NIV can be stopped at the patient’s request; dependence makes expert planning for symptom control and support more important, not less lawful. The conversation is offered rather than imposed, and family involvement follows the patient’s wishes. Delay risks losing the clearest route to autonomous planning.

Reference: NICE NG42 motor neurone disease recommendations: https://www.nice.org.uk/guidance/ng42/chapter/Recommendations