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MCQ 10: Advance Care PlanningA 70-year-old man with advanced heart failure is admitted with acute decompensation. He has capacity and expresses a wish not to be resuscitated. What is the most appropriate next step?A. Ignore the request as it wasn't made in writingB. Discuss and document a DNACPR orderC. Consult the patient's family before making a decisionD. Insist on attempting resuscitation regardlessE. Refer to the hospital ethics committeeAnswer: Discuss and document a DNACPR orderExplanation: When a patient with capacity expresses a wish not to be resuscitated, it's crucial to have a detailed discussion about their preferences and document a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) order. This respects patient autonomy and ensures their wishes are followed. A verbal request is valid; it doesn't need to be in writing initially. While family discussions can be helpful, the patient's autonomous decision takes precedence. Ignoring the request or insisting on resuscitation would be unethical and potentially illegal. Ethics committee referral is unnecessary for a clear, capacitous decision.