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Best interests decision — DGM MCQ

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HardEthics and lawBest interests decisionDGM

An 89-year-old man with advanced dementia lacks capacity to decide about surgery for bowel obstruction. He has no advance decision and no LPA. His daughter says he valued comfort and feared hospitals; the surgeon says surgery has high mortality. What is the most appropriate management?

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

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Correct answer: E — Best-interests decision incorporating prior values, clinical benefits and family views

Where a person lacks capacity and no valid advance decision or LPA applies, clinicians make a best-interests decision after considering medical factors, prior wishes and consultation with those close to the person. Family members inform the decision but do not automatically make it. Best interests are broader than survival and include burdens, values and dignity.

Reference: Mental Capacity Act 2005; NICE NG108