ACP – early introduction — RACP Paediatrics MCQ

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ModerateNeurologyACP – early introductionRACP Paediatrics

A family of a child with SMA type 1 (on nusinersen) asks about advance care planning (ACP). When should ACP discussions occur?

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Correct answer: D — Palliative care alongside curative treatment

Advance care planning should be introduced early and revisited regularly as the disease and family's understanding evolve. ACP is not about 'giving up' – it involves understanding the child's condition, discussing goals of care, preferences for escalation of treatment, and what the family values for their child's quality of life. It should occur alongside active management.

Reference: RCH Melbourne – 2025 – Paediatric Palliative Care Guidelines; RACP – 2021