end of life talk

Question 1

what is palliative care

Answer 1

Provides relief from pain and other distressing symptoms
Affirms life and regards death as a normal process
Intends neither to hasten or postpone death
Offers a support system to help patients live as actively as possible until death
Offers a support system to help the family cope during the patients illness and in their own bereavement

Question 2

what is the WHO definition of palliative care

Answer 2

Uses a team approach to address the needs of patients and their families, including bereavement counselling if indicated
Will enhance quality of life, and may also positively influence the course of illness
Is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy, and includes those investigations needed to better understand and manage distressing clinical complications

Question 3

Principles of medical ethics

Answer 3

Beneficience – do good
Non-maleficence – do no harm
Autonomy – respect the individuals right to self-determination, depends on info given, cognition and mood
Justice – be fair, depends on resources

Question 4

DNACPR forms

Answer 4

NOT a legal document
Record of a clinical decision
Communication tool, provide guidance for HCPs who do not know the patient

Must document discussions in medical notes
‘Psychological or physical harm’
Must speak to NOK

Question 5

withdrawal of treatment with capacity

Answer 5

Respect patients right to stop life sustaining treatment

Continuing unwanted treatment is battery and a criminal offence

Artificially sustaining life, treatment no longer of benefit.
Unnecessarily burdensome

Question 6

Guidelines – Withdrawing & Withholding Treatments

Answer 6

Respect for human life & patient’s best interests primary concern
Respect patients’ wishes – competent adults have right to refuse treatment.
Respect any advance refusals unless uncertainty
If treatment not in best interests there is no obligation to provide it
No distinction between not starting and withdrawing treatment
End of natural life
Clinical evidence
Assess benefits and burdens
Non-discrimination
Accountability