ethics

Question 1

Ethical Framework

Answer 1

1. Organisation = intergrity, impartiality, transparency, accountability, promoting the public good
2. Professional = respect, culturally competent, human rights
3. Personal = depends on individual

Question 2

Capacity

Answer 2

understand nature and effect of decisions, freely and voluntarily make decisions and communicate these in some way.
Always assume someone has capacity
Once capacity is lost an Enduring Power of Attorney steps in

Question 3

NDIS = National Disability Insurance Scheme

Answer 3

Have an impairment condition that:
o Is likely permanent
o Reduces ability to participate in activities or perform tasks – unless assistance/assistive technology present; or can’t participate even with assistance/aides/equipment).
o Affects capacity for social/economic participation
o Likely to require support from NDIS for lifetime.

Question 4

Palliative Care:

Answer 4

• Improving the QOL of patients and their families by trying to eliminate suffering from patients with life-threatening illnesses
• If someone is palliative get more funding for equipment at home / nursing in-home.

Question 5

pallative care things to consider:

Answer 5

o Age of the patient
o Traumatic vs. known illness
o Family / staff reactions de-briefing

• CgDp = Clinical guidance for the dying patient:
o Assessed as being in last hours of life.
o Have an ARP that states not for CPR.
o Daily r/v by treating team

• ARP = Acute Resuscitation Plan:
o Decision regarding:
♣ CPR
♣ Level of intervention IV antibiotics, IV fluids, MERTS, ICU

Question 6

• Advanced Health Directive

Answer 6

o Make choices about health care they do/do not want if they can no longer make decisions for themselves.
o Name religious, cultural, spiritual beliefs.

Question 7

• If someone dies on the ward:

Answer 7

o Curtains closed + doors closed + butterfly on door.
o Med team + family notified
o Paperwork completed and documented in chart
o Cleaning and preparation of body Transfer of body to morgue – discreet

Question 8

Physiotherapy’s role ***

Answer 8

improve QoL in last few weeks/days
• Assess mobility / educate on mobility decline / teach family how to assist mobility.
• When to cease? consider prognosis, patient/family wishes, MDT meetings.

Question 9

Death

Answer 9

• Brain Dead or Cardiac Death
• Brain Dead no response to tests, like: pupillary reflex, pressure on nail bed, corneal reflex, cough reflex etc.
• Circulatory Death Immobility, apnoea, absent skin perfusion, absent arterial pulse (>2mins). Organ donation must occur within 90 minutes of circulatory death.

Question 10

Physiotherapy and Organ Donation:

Answer 10

• Maintain lung function (keep chest clear)
• Minimise oxygen required to maintain PaO2
• Continues until organ surgery
• RESPECT the family of the patient