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LPA Health and Welfare — MRCPsych Paper B MCQ

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ModerateOld Age PsychiatryLPA Health and WelfareMRCPsych Paper B

Mr Khan made and registered a Lasting Power of Attorney for Health and Welfare under the Mental Capacity Act 2005, appointing his sister as his sole attorney. The document gives her general health and welfare powers but states that she is not authorised to give or refuse consent to life-sustaining treatment. Mr Khan now lacks capacity both to decide where he should live and to decide about proposed life-sustaining treatment. Which statement best describes his sister's authority?

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

Reveal the answer and explanation

Correct answer: D — Decide his residence in his best interests, but not consent to or refuse life-sustaining treatment.

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

B is correct. A registered Health and Welfare LPA allows the attorney to make covered decisions only when the donor lacks capacity for the particular decision. Residence and care arrangements ordinarily fall within its scope, and the attorney must decide in the donor's best interests. However, an attorney may consent to or refuse life-sustaining treatment only if the LPA expressly grants that authority; it was withheld here. A is incorrect because financial powers require a separate Property and Financial Affairs LPA. C is incorrect because prior Court of Protection approval is not routinely required for a decision within the attorney's authority. D reverses the stated scope. E is incorrect because the GP does not automatically become the sole decision-maker, although clinicians retain responsibility for treatment decisions outside the attorney's authority.

Reference: Office of the Public Guardian. LP12 Make and register your lasting power of attorney: a guide, sections 'Health and welfare decisions' and 'Life-sustaining treatment', updated 20 April 2026. https://www.gov.uk/government/publications/lasting-power-of-attorney-forms/lp12-make-and-register-your-lasting-power-of-attorney-a-guide-web-version