Ethics: Families and end of life decisons

Question 1

Points of conflict when planning an expected death

Answer 1

• Sanctity of life requirements
• What is futility
• Childs situation: facts and values
• Future possibilities

Question 2

Three important things to consider when planning a death

Answer 2

• Treating team is responsible for serving patients best interests, and should be open to discussion with family input.
• Parental investment in making a decision is huge, but cannot outweigh childs interests
• Negotiation may help

Question 3

What are reasons some requests may be futile?

Answer 3

 Patients reason for their request? (e.g. Keep my husband alive for superannuation)
 Is it a life or death decision?
 Who considers the request to be futile? On wat grounds? Who is the best judge?
 What are the risks of the treatment that you deem futile? Is the risk high because of changeable patient factors?
 Are there other options to help the patient?
 What is the cost of the futile treatment?
 What will the impact be on the patient-doctor relationship?

Question 4

What is an advanced directive and doctors role

Answer 4

A written or oral directive:
A) By which a consumer makes a choice about a possible future health procedure, and
B) That is intended to be effective only when he or she is not competent.

Only come into consideration when someone loses their mental capacity. Doctors must act in the patients best interests, guided by the directive.

Question 5

Advanced directives disadvantages

Answer 5

• If advance directives are made a long term before loss of capacity, treatment options may have changed a lot.
• Can not encompass unforeseen possibilities and options, i.e patients perspectives on a tolerable existence can change over time.

Question 6

HDC code of rights applicable to end of life and family assisted services

Answer 6

Code 7: Right to make and informed choice and give informed consent.
Code 8: Right to have support