end of life issues Flashcards
when is it unlawful to treat?
if a competent patient gives no consent for treatment
what was the Kerrie Wolltorton case in 2007?
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
what were the concerns with the KW case?
she had an untreatable emotionally unstable personality disorder and was depressed at the time of decision
what were the outcomes of the trial?
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
what is not considered in law as assisted suicide?
complying with the refusal of treatment in a patient that has attempted suicide
what is assisted suicide?
if a person carries anything out that is intended to encourage or assist suicide
how should patients questions be answered?
honestly unless is thought to be about suicide and then should avoid
what are the options if you have a patient that wants assisted suicide?
ensure the patient has been offered palliative care to provide an alternative and alleviate symptoms and consider natural death
how should decisions be made on withdrawing or withholding life prolonging treatment?
the decisions are made on overall benefit in the patients best interests
should a treatment be provided all the time?
no legal obligation if it is not clinically appropriate and has no overall benefit
what does the patient not have a right to do?
demand a certain treatment - their wishes are informative not decisive
what is PVS?
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
what is needed to survive in PVS?
CANH but not artificial ventilation
when can CANH be removed?
when the family and doctor agree - if not goes to court
what is passive euthanasia?
where there is an omission to provide treatment where intention is to bring about death for the patients benefit
what is active euthanasia?
where there is a positive act such as a lethal injection
which is illegal in the UK?
active
what is the difference between the two types of euthanasia ?
active has the intention of death whereas passive is omission because of the overall lack of benefit to the patient
when is DNACPR used?
when it has been discussed with the patient if they have capacity at the point of decision
why are there arguments for euthanasia?
dignity, relieves suffering, respects judgement and autonomy
what do patients have the right for?
right to refuse treatment that would keep them alive but not the right to death
when does article 3 come into force?
when there is inhumane treatment or act inflicted by the state that is unbearable
what is the doctrine double effect?
it is when you can carry out an act that has a good an a bad effect
what are the criteria for the doctrine double effect?
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
what is the doctrine double effect usually used in relation to?
providing opiates to control pain in terminal conditions - can cause respiratory depression - argument for euthanasia - no other way to manage pain
what is the issue with the doctrine of double effect?
hard to determine what a doctors intentions are
