Phys Clinical Cases · general-medicine
END OF Life Decision Making — DCE Clinical Case
DCE long-case and short-case station for END OF Life Decision Making.
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END OF Life Decision Making — Clinical Case
DCE Long Case
Patient brief
Patient: A middle-aged or older adult with multimorbidity and a presentation centred on END OF Life Decision Making. [1]
Presenting complaint: Subacute or acute symptoms referable to END OF Life Decision Making, with enough detail to force prioritisation. [1] [2]
Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]
Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]
Examination: Key positives and critical negatives for dangerous differentials. [1]
Investigations: A small set of results that change management. [1] [2]
Tasks
- Present a prioritised problem list. [1]
- Defend investigations and immediate therapy. [1] [2]
- Provide safety-net and follow-up advice. [2]
Model discussion points
- Working diagnosis and acuity. [1]
- Differentials and discriminators. [2]
- Treatment sequence and monitoring. [1] [2] [3]
- Multimorbidity and communication. [2]
You have read the opening of this clinical case. The complete unit — every section and its primary-source references — is part of the Physician Medicine fellowship atlas.
References8Show ledgerHide ledger
- [1]Bolton P, White BP, Huppert J, Dadich A Assisted Dying Makes Us Think Differently About Care Health Expect, 2026.PMID 42460812
- [2]Bergen K, Bouwmans P, van Oevelen M, Avesani CM, et al. Deciding between conservative kidney management and dialysis in older people with kidney failure: a narrative review Clin Kidney J, 2026.PMID 42459744
- [3]Hoftiezer L, Hof MHP, van Lingen RA, Hukkelhoven CWPM, et al. Beyond cut-offs: gestational age-specific perinatal mortality across the birthweight-for-gestational-age continuum-a population-based cross-sectional study Eur J Pediatr, 2026.PMID 42458127
- [4]Aljohar A, Williamson MD, Mitchell RA, Roston TM, et al. Arrhythmogenic Right Ventricular Cardiomyopathy in Athletes: The Importance of Shared Decision-Making and an Individualized Approach JACC Case Rep, 2026.PMID 42460947
- [5]Genoud A, Portugal I, Murith N, Deux JF, et al. Coronary Artery Anomalies Revisited: Description of the Types, Pathophysiology and Treatment Options Based on Latest Guidelines J Clin Med, 2026.PMID 42452422
- [6]Shah V, Constantin K, Taddio A, McMurtry CM, et al. A Systematic Review and Meta-Analysis of the Effectiveness of Physical Interventions Administered Orally for Infants for Reducing Distress During Vaccine Injections Clin J Pain, 2026.PMID 42444178
- [7]Doan HN, Chang MC Comparative Effectiveness of Unstable Versus Stable Resistance Training on Lower Limb Strength, Mobility, and Fear of Falling in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials Am J Phys Med Rehabil, 2026.PMID 42468010
- [8]Liu HW, Tsai TL Virtual Reality-assisted Physiotherapeutic Training for Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis Am J Phys Med Rehabil, 2026.PMID 42468005