decision making at end of life Flashcards
1
Q
2 main aspects of making goals of care decisions
A
- shared decision making
2. informed consent
2
Q
4 parts of shared decision making
A
- explore pt/family preferred role
- elicit pt values
- provide info
- deliberation and decision making
3
Q
4 parts of meeting
A
- prep
- 1st half
- 2nd half
- summarize
4
Q
parts of 1st half
A
- intro
- defuse tension
- establish rapport
- active listening
- open ended Qs
5
Q
parts of second half
A
- present info
- establish goals of care
- agree on Tx plan
6
Q
**3 parts of consent
A
- informed
- capable
- voluntary
7
Q
4 broad Tx cats
A
- full code
- DNR with ICU admission
- DNR without ICU admission
- comfort only
8
Q
4 model of deicsion making
A
- parental - phys is guardian
- interpretive - phys is counsellor
- informative/consumer - phys is tech
- deliberative - phys is teacher
9
Q
what is effect of CPR and ventilation
A
not very good and people think it worls better
- lots of SE
10
Q
what are fears
A
- fear of neglect
- ## bizarrre requests
11
Q
what is autonomy
A
- must be informed and advised
- shifting responsibilty to patient/family is NOT respecting autonomy
12
Q
5 parts to bottom line
A
- communication process is important
- explore understanding
- explore values
- explain concerns
- frame ACP as contingency plan
13
Q
2 types of advanced care plans
A
- power of attorney
2. living will
14
Q
5 myths about why not to tell
A
- doesn’t want to know- most people do
- conversation is traumatic
- will become depressed
- no correlation - pos. attitude will help overcome
- no diff - going to die, so not big diff.
- can do lots of things
15
Q
4 different views on non-benefical Tx
A
- not effective
- not cost-effective
- effective, but too high burdens
- proces related issues
