end of life ethics Flashcards
good death
communications symptoms well controlled not distressing time to plan preferred place of death
bad death
poor communication distressing symptoms sudden catastrophic e.g. bleed no time to plan ahead disagreement
collusion
secret agreement made between clinicians and family members to hide diagnosis of a serious or life-threatening illness from patient
reasons families may wish to collude
disclosure causes pt to loose hope disclosure leads to depression disclosure inc risk pt suicide family memnbers in denieal/in conflict disclosure may cause pt psychological pain
why collusion goes against best practice: patient factors
- at odds with pt autonomy and right to self-determination
- breach medical confidentiality revealing diagnosis to family first
- patient unable to give informed consent, may miss out on best/timely Rx
- pt unable to complete unfinished business
why collusion goes against best practice: family factors
- bear burden of being untruthful, lead to guilt
- barrier to communication
why collusion goes against best practice: clinician factors
- breakdown of clinician-patient relationship, loss of trust
- non-compliance frmo patients
DNACPR forms
not legal document
record of decision
provide guidance for clinicians who don’t know pt
if not discussed w pt need to document rationale in notes
DNACPR guidance
- pt myst be aware of form
- if lack capacity must inform family
when is letting die medically acceptable
medical technology useless
patient validly refuse medical technology
euthanasia
act of deliberately ending patient’s life to relieve sufferent
assisted suicide
act of deliberately assisting/encouraging another person to kill themselves
physician assisted suicide
prescribing lethal drugs intended explicitly to end life
pt takes drugs themselves
