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Timing and Framing of ACP Conversations — SCE Palliative Medicine MCQ

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EasyNon-Malignant Palliative CareTiming and Framing of ACP ConversationsSCE Palliative Medicine

A 75‑year‑old man with advanced COPD and heart failure is admitted with a COPD exacerbation. He improves with treatment. Before discharge, the palliative care team is asked to review him for advance care planning. He says, 'I’m fine now — why are you talking to me about death?' How should this be handled?

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Correct answer: E — Acknowledge that he feels better now, explain that ACP is about planning for the future (not about dying now), frame it as empowerment and control, and offer to revisit the discussion at a later appointment if he prefers

Option E is correct. NICE Quality Standard QS13 emphasises that advance care planning (ACP) is voluntary and should be offered with sensitivity; if a person is not ready, the discussion may be deferred ([nice.org.uk](https://www.nice.org.uk/guidance/qs13/chapter/Quality-statement-2-Advance-care-planning?utm_source=openai)). NHS England’s Universal Principles for ACP recommend starting conversations at the person’s pace, focusing on what matters to them and respecting their readiness ([england.nhs.uk](https://www.england.nhs.uk/wp-content/uploads/2022/03/universal-principles-for-advance-care-planning.pdf?utm_source=openai)). Option D is coercive and conflicts with voluntariness. Option A is dismissive and undermines rapport. Option C misses an important opportunity to plan later. Option B is inappropriate abandonment of care.

Reference: NICE QS13 Quality statement 2 (2021); NHS England Universal Principles for Advance Care Planning (2022) — URLs cited in evidence, https://www.nice.org.uk/guidance/qs13/chapter/Quality-statement-2-Advance-care-planning