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Realistic Expectations About Dying — SCE Palliative Medicine MCQ

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EasyEnd of Life CareRealistic Expectations About DyingSCE Palliative Medicine

A 68-year-old woman with advanced cancer asks her palliative care nurse about the concept of 'a good death.' She says she wants to die like her mother—'peacefully in her sleep.' Is this a realistic expectation?

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Correct answer: E — While many deaths are peaceful, realities vary—honest preparation for what dying may involve (symptoms, physical changes, emotional responses) alongside reassurance that the palliative team will manage symptoms proactively is most helpful.

Option E is correct. NICE NG31 emphasises that clinicians should establish a patient's expectations about dying, provide accurate information about prognosis, acknowledge uncertainty, and avoid false optimism while proactively managing symptoms. Many deaths may be peaceful, but variability is the norm, and preparing patients honestly while reassuring them regarding symptom control reflects best practice. Option D is incorrect—peaceful death cannot be guaranteed. Option B is unrealistic and ignores the need for dialogue and planning. Option A contradicts guidance encouraging open, sensitive discussions. Option C is pessimistic and ignores the role of palliative care in minimizing distress and supporting comfort.

Reference: NICE NG31: ‘Care of dying adults in the last days of life – Communication recommendations’, 2015; NHS.uk ‘What to expect from end of life care’, reviewed 6 May 2026. https://www.nice.org.uk/guidance/ng31/chapter/Recommendations