ethics case II around PVS and EoL Flashcards
what is PVS?
it is a state that is caused by damage to the brain resulting in a lack of evidence of awareness of the self, environment, interaction with others and / or comprehension or expression of language
what is needed to survive in PVS?
CANH
why is artificial ventilation not needed in a PVS?
the cardio-respiratory function is intact
what was the controversial PVS case in 1993?
Airedale NHS trust vs Bland - the family wanted to withdraw CANH but the doctor did not
what happens if the MDT and the family disagree about CANH withdrawal?
court approval must be sought
why is removal of CANH not considered a criminal act?
continued provision of CANH would not be in the best interest of PVS patient and therefore there is no duty to continue providing. The treatment is futile and there is not treatment that will improve the condition
what happened in July 2018 with the Bland Case?
the doctor and the family agreed on withdrawing the CANH therefore needed no court approval as it is not the desire to kill but due to lack of medical benefit
what does medical ethics prohibit with regards to CANH?
making decisions that are motivated by desire to end life - decisions concerning potentially life prolonging treatment must not be motivated by a desire to bring about patient’s death
what is euthanasia and what are the types?
it has the intention to bring about death and can be passive where there is omission to provide treatment or active which is a positive act such as a lethal injection
what are the defining features of passive euthanasia and what must it be differentiated from?
it is the intention to bring about a patient’s death for the patient’s best interests or good and is not the same as witholding life prolonging treatment
what is the law with regards to CPR?
there is no legal obligation to provide CPR if it is futile however as of 2014 it must be discussed with the patient or the family if the patient is not competent if you are not planning on providing it
what needs to be considered with euthanasia?
the right to life does not mean there is a right to death
what does the HRA about a private and family life state about a DNACPR?
it concerns how an individual chooses to pass their closing days and moments and how their death is managed - it is a decision around the patient’s autonomy and the patient must be involved in decisions that potentially concern the deprivation of life saving treatments
when would a patient not be involved in their decision for DNACPR?
when it would likely cause psychological or physical suffering - if they find the topic distressing to talk about this is unlikely to qualify to these criteria
what types of information are considered by court around DNACPRs?
their religious views, views on autonomy, living in such a way or life centred around disability, if they would want to prolong life through treatment, that life is not worth less is chronically ill or disabled and what they may have said previously
