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Substitute decision-making and advance directives — MCCQE Part 1 MCQ

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HardEthics & ProfessionalismSubstitute decision-making and advance directivesMCCQE Part 1

An 85-year-old woman with advanced HF, admitted with pneumonia. POA daughter insists on full resus. Patient previously expressed (documented) she would not want CPR/ventilation. Patient now lacks capacity. Most appropriate action?

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

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Correct answer: A — Follow patient's previously expressed wishes as documented

SDM must follow patient's prior capable wishes, not own preferences. Health Care Consent Act (ON) and equivalents. If wishes are unknown, SDM uses best interests standard. Goals-of-care conversations should be documented.

Reference: Provincial Health Care Consent / CMA Ethics