Ethics tissue donation and end of life care

Question 1

Who can refuse treatment ?

Answer 1

Any competent patient can refuse any treatment, make an advance refusal of treatment (ART) or appoint a proxy decision maker

Question 2

Regarding deciding if a patient has the capacity to decide about their care what do you assume ?

Answer 2

That they have the capacity regardless of:

• Age
• Disability
• Appearance
• Behaviour
• Medical condition (including mental illness)
• Beliefs
• Apparent inability to communicate
• Decision that others disagree with or consider unwise

Question 3

What do you do if a patient does not have the capacity to make there own decisions ?

Answer 3

• Check if there is a legal proxy to make decisions (someone was given legal power of attorney)

And

• Check if the patient made legally binding advance decision or directive

Question 4

If a patient did not declare a proxy and did not make an advanced decision or directive then what do you do ?

Answer 4

• Consult with those close to the patient
• Consult with members of the healthcare team
• Do what is best for the patient

Question 5

When is it acceptable to withhold or withdraw life-prologing treatment ?

Answer 5

• If competent patient requested it: special safeguards must be in place
• If its best for the patient
• If the treatment is futile

Question 6

When is it acceptable to give treatment that might cause the patients death?

Answer 6

• Only under the DOCTRINE OF DOUBLE EFFECT (DDE)
• DDE explains the permissibility of an action that causes a serious harm, such as the death of a human being, as a side effect of promoting some good end
• Death is not the main cause, but secondary side-effect e.g. giving morphine for pain relief in palliative care

Question 7

What is the system for organ donation in this conuntry ?

Answer 7

OPT IN - you can use the tissue only if those closest to the patient agree or the patient has already opted in