end of life issues

Question 1

when is it unlawful to treat?

Answer 1

if a competent patient gives no consent for treatment

Question 2

what was the Kerrie Wolltorton case in 2007?

Answer 2

she drunk antifreeze and called an ambulance and had done 9 previous times and accepted treatment. The last time she made a decision with a solicitor to only have comfort care and therefore would have been unvalid and unlawful to treat

Question 3

what were the concerns with the KW case?

Answer 3

she had an untreatable emotionally unstable personality disorder and was depressed at the time of decision

Question 4

what were the outcomes of the trial?

Answer 4

presence of mental health disorder is not evidence of lack of capacity however, accord to MCA a competent patient can be treated against their will to prevent self harm or suicide as a treatment seen to be in their best interests

Question 5

what is not considered in law as assisted suicide?

Answer 5

complying with the refusal of treatment in a patient that has attempted suicide

Question 6

what is assisted suicide?

Answer 6

if a person carries anything out that is intended to encourage or assist suicide

Question 7

how should patients questions be answered?

Answer 7

honestly unless is thought to be about suicide and then should avoid

Question 8

what are the options if you have a patient that wants assisted suicide?

Answer 8

ensure the patient has been offered palliative care to provide an alternative and alleviate symptoms and consider natural death

Question 9

how should decisions be made on withdrawing or withholding life prolonging treatment?

Answer 9

the decisions are made on overall benefit in the patients best interests

Question 10

should a treatment be provided all the time?

Answer 10

no legal obligation if it is not clinically appropriate and has no overall benefit

Question 11

what does the patient not have a right to do?

Answer 11

demand a certain treatment - their wishes are informative not decisive

Question 12

what is PVS?

Answer 12

damage to the brain resulting in a lack of evidence of awareness of the self or environment, of interaction with others or of comprehension or expression of language

Question 13

what is needed to survive in PVS?

Answer 13

CANH but not artificial ventilation

Question 14

when can CANH be removed?

Answer 14

when the family and doctor agree - if not goes to court

Question 15

what is passive euthanasia?

Answer 15

where there is an omission to provide treatment where intention is to bring about death for the patients benefit

Question 16

what is active euthanasia?

Answer 16

where there is a positive act such as a lethal injection

Question 17

which is illegal in the UK?

Answer 17

active

Question 18

what is the difference between the two types of euthanasia ?

Answer 18

active has the intention of death whereas passive is omission because of the overall lack of benefit to the patient

Question 19

when is DNACPR used?

Answer 19

when it has been discussed with the patient if they have capacity at the point of decision

Question 20

why are there arguments for euthanasia?

Answer 20

dignity, relieves suffering, respects judgement and autonomy

Question 21

what do patients have the right for?

Answer 21

right to refuse treatment that would keep them alive but not the right to death

Question 22

when does article 3 come into force?

Answer 22

when there is inhumane treatment or act inflicted by the state that is unbearable

Question 23

what is the doctrine double effect?

Answer 23

it is when you can carry out an act that has a good an a bad effect

Question 24

what are the criteria for the doctrine double effect?

Answer 24

the bad must be outweighed by the good and an unavoidable side effect of the good for the patients best interests - you must only intend the good and symptoms must be so severe they are detrimental to patient and have to explain to a competent patient

Question 25

what is the doctrine double effect usually used in relation to?

Answer 25

providing opiates to control pain in terminal conditions - can cause respiratory depression - argument for euthanasia - no other way to manage pain

Question 26

what is the issue with the doctrine of double effect?

Answer 26

hard to determine what a doctors intentions are