You are working on a medical ward when you are asked to see a patient who has suffered a probable stroke. The patient is a seventy eight-year-old man who was admitted for treatment of a urinary tract infection - he has a dense hemiplegia and dysphasia. After referral to the stroke team his diagnosis is confirmed but thrombolysis cannot be performed as he has a large space occupying lesion. His wife is present and produces an advanced care directive - the directive is signed, dated and countersigned. Within it, the directive expresses that in the event of life limiting illness treatment should be given regardless of contra-indications. His wife explains this was written specifically after he developed his brain tumour in case he had a stroke. How should you proceed?
Perform the thrombolysis as the patient was aware of the risks and the directive is valid
Refuse to perform the thrombolysis as the directive is not written on headed paper and is therefore invalid under law
Refuse to perform the thrombolysis as advanced directives cannot be used to demand treatment
Explain to the wife that the directive should have been given to the hospital on admission and as it was not it is therefore invalid
Perform the thrombolysis as the patient has no DNACPR in place and his quality of life may be much improved by intervention
Answer is C