skip to main content

Advance decision refusing antibiotics — SCE Geriatric Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardEthics and lawAdvance decision refusing antibioticsSCE Geriatric Medicine

An 83-year-old man with mild dementia has aspiration pneumonia after a stroke. He lacks capacity to decide about antibiotics today, but an advance decision refusing antibiotics for any future chest infection is found; it is signed, witnessed and explicitly states it applies even if life is at risk. His son asks the team to ignore it. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: B — Respect the valid and applicable advance decision while providing comfort-focused care

A valid and applicable advance decision to refuse life-sustaining treatment must be respected, even if family members disagree. Best-interests decision-making applies when there is no valid applicable ADRT or LPA decision. Comfort-focused care, symptom control and communication remain essential. The pearl is that advance refusals are legally stronger than informal preferences when statutory requirements are met.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/neurological-conditions/dementia