Question

A 69-year-old man with capacity and advanced motor neurone disease writes a detailed advance decision to refuse tracheostomy and prolonged ventilation in the event of respiratory failure. Two years later he presents with acute respiratory failure and is unconscious. The advance decision is available and clearly applicable. What should you do?

Accepted Answer

Respect the advance decision and do not provide tracheostomy and prolonged ventilation

Answer

Ignore the advance decision and ventilate because the situation is life-threatening

Answer

Seek consent from relatives to override the advance decision

Answer

Apply to the court before making any decision

Answer

Treat him as if he lacks capacity and make a best interests decision without reference to the advance decision

Practice question