Supporting patients to make decisions about their care at the end of life


This case study supports the information on mental capacity in our ethical hub. It aims to help explain how certain principles in our guidance should be applied to patients and in practice.

  • Each case study begins with the patient’s notes to set the scene and the characters
  • The grey boxes tell the story
  • The blue boxes summarise the doctor’s considerations and/or actions
  • At the end of each case study we highlight the paragraphs in our guidance for your reference


Sally Jackson is 49 years old and has Down's syndrome. She was diagnosed with breast cancer and has been receiving chemotherapy. Recent tests show that the cancer has spread and is terminal.

Dr Michaels (oncology SpR) has to inform Sally of her diagnosis and go through her options.   

Read the complete case study