A 65-year-old woman with motor neurone disease has a valid advance decision to refuse treatment (ADRT) that specifically refuses invasive mechanical v...

Question

A 65-year-old woman with motor neurone disease has a valid advance decision to refuse treatment (ADRT) that specifically refuses invasive mechanical ventilation. She is now admitted to ICU with aspiration pneumonia and is in type 2 respiratory failure (pH 7.22, PaCO2 9.5 kPa). She is drowsy and lacks capacity. Her husband, who holds lasting power of attorney (LPA) for health and welfare, requests that she be intubated and ventilated. What is the correct legal position?

Accepted Answer

The valid and applicable ADRT must be respected - invasive ventilation must not be provided

Answer

The LPA holder's request overrides the ADRT - proceed with intubation

Answer

The clinical team should seek an urgent Court of Protection ruling

Answer

The clinical team should intubate in the patient's best interests as she is critically unwell

Answer

An IMCA should be appointed to adjudicate between the ADRT and the LPA holder's wishes

uk-fficm MCQ (SBA): Advance Decision to Refuse Treatment