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Published online by Cambridge University Press:  02 January 2018

Ollie Minton*
Affiliation:
St George's University NHS Foundation Trust, London, UK; email: [email protected]
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Creative Common License - CCCreative Common License - BY
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Copyright © Royal College of Psychiatrists, 2016

We thank Dr Waite for alerting readers to further useful guidance on advanced care planning. While we agree that there is much to be done from the 2009 Royal College of Physicians report, we have chosen to address the aspects of Mrs S's end-of-life care. In particular, we have focused on the synergies between the psychiatric staff and the local hospice.

On one particular point we stated that people can express their wishes about preferred place of treatment in an advance decision. However, we never stated that an advance decision is always binding – on the contrary, we said that Mrs S's was invalid.

The debate raised around Burke v GMC is around providing treatment not in a patient's best interests and is not directly relevant to our paper.

However, Dr Waite's final broader point that ‘ascertaining how patients would like to be treated when they are unable to make decisions for themselves should be part of routine practice with all psychiatric patients’ is welcomed.

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