Clinical Ethics Committee Referral — SCE Palliative Medicine MCQ

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HardLegal & Ethical FrameworkClinical Ethics Committee ReferralSCE Palliative Medicine

A dying patient’s family disagree with the clinical team about withdrawing IV fluids. The clinical team believes IV fluids are worsening her oedema and secretions without benefit. The family believe stopping fluids is 'killing' her. Mediation has failed. What is the next step?

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Correct answer: E — Referral to the hospital clinical ethics committee for advice — providing structured, multidisciplinary, independent ethical assessment

Clinical ethics committees are explicitly recommended in UK guidance (BMA Best Interests Toolkit, 2019) as a formal local mechanism to resolve disagreements over best‑interests decisions in incapacitated adults, before seeking legal advice or application to the Court of Protection ([mg.salisbury.nhs.uk](https://mg.salisbury.nhs.uk/media/3975/bma-best-interests-toolkit-2019.pdf?utm_source=openai)). Similarly, GMC guidance on decision‑making and consent endorses local resolution via ethics committee after initial steps like mediation have failed, prior to court ([rightdecisions.scot.nhs.uk](https://rightdecisions.scot.nhs.uk/media/1858/gmc-guidance-for-doctors-decision-making-and-consent-english_pdf-84191055.pdf?utm_source=openai)). Referral avoids premature legal escalation (Option E) or unilateral action (Option C), respects professional standards and family involvement, and avoids inappropriate assumptions that the family automatically prevails (Option D) or that transfer (Option B) is necessary.

Reference: BMA Best Interests Toolkit (Section 9: Disputes, 2019), and GMC Guidance on Decision‑Making and Consent (Resolving disagreements, ~2024). https://mg.salisbury.nhs.uk/media/3975/bma-best-interests-toolkit-2019.pdf