Ethics of Tissue Donation Flashcards
What are the basic ethical principles in end of life care?
Principles of autonomy and best interest apply
Mentally competent patient can refuse any treatment
Can appoint proxy or make advance refusal of treatment
What must you presume?
That all patients have capacity = irrespective of age, disability, appearance, behaviour, medical condition, beliefs and decisions that others disagree with
What should happen if a patient has capacity?
The patient should make decisions with the medical team
What must be checked if a patient no longer has capacity?
Check if there is a legal proxy to make decisions
Check if patient made legally binding advance decision or directive
What does refusal of treatment include?
Withholding and withdrawing treatment = may be artificial feeding or mechanical respiration
What must advance refusal of treatment (ART) state?
That decision applies even if life is at risk
Must be in writing, signed and witnessed
Must be valid and applicable to treatment
What occurs if there is no proxy or advance directive?
Consult with those close to the patient, consult with medical team, do what is best for patient
What must you do when consulting about end of life decisions when the patient doesn’t have capacity?
Try to find out what the patient would’ve wanted = don’t make assumptions based on what you would want
What is the rule about decisions concerning potentially life prolonging treatment?
Must not be motivated by a desire to bring about a patient’s death
When is it acceptable to withhold or withdraw treatment?
If a competent patient has requested it (safeguards must be in place), if it is the best option or if treatment is futile
When is giving treatment that may cause death acceptable?
Only under doctrine of double effect (DDE) = explains the permissibility of an action that may cause serious harm as a side effect of promoting some good end
What kinds of assisted suicide are illegal in the UK?
All kinds = includes physician-assisted suicide or suicide assisted by any healthcare professional
What is the legislation relevant to tissue donation?
European Tissue and Cells Directive (2004), Human Tissue (Scotland) Act (2006)
What type of cells have special legislation around them?
Reproductive cells = extra safeguards in the Human Fertilisation and Embryology Act (2008)
What are the rules about tissue donation?
All tissues have to be used appropriately (includes saliva and blood), and no trading of tissues is allowed
