Lecture 8- 'A good death' Flashcards
who can have a good death
perhaps on those who have to die
e.g. have a life threatening progressive incurable disease which is far advanced with a limited prognosis and the focus of care is quality of life
A philosophy of care is needed
- For instruction on the management of dying patients
- A science of symptom control and communication
- ‘to live until they die’- Cecily Saunders
- ‘special care’ required for the dying (cancer and non cancer
- Care involves physical, psychological, emotional , social and spiritual (total) care
many challenges with achieving a ‘good death’
truthfulness (honest/open) with patients
enabling informed consent
allowing time to prepare
avoiding isolation
overcoming a wall of silence
maintaining hope by accompanying them on the journey
NEVER say
‘there is nothing more that can be done’
when do we transition from cure to palliation
at the point of futility- where curative treatment is continued where this is no prospect fo scucess
Anticipatory grief- Kubler Ross
abigail did buy dreadfull apples
Suffering
- Suffering can be equated with inadequate palliative care
- If there is suffering the provision of palliative care to an individual requires urgent review by a specialist
- Any thought of euthanasia/physician assisted suicide is not a provision of good dying but a failure of communication and palliative care
care needed for carer to ensure a ‘good death’
- lots of support and input required
- opportunities for respite
- grief before and after death
- ensur they do not feel guilty that they have failed their loved on in any way
principles of good health- BMJ 2000
list several specific distinct services or interventions offered by many modern UK hospices to patients with life- limiting illnesses (using an example of end stage heart failure or end stage COPD as an example)
- OT
- PT
- GP medication review
- counselling
- district nurse care
- respite for carer
list several specific challenges in achieving a ‘Good
Death’
- not managing pain
- when the patient cant give informed consent due to deterioration- wishes may not be fullfilled
- not being with family e.g. coronavirus
- stresses on NHS e.g. dont have the resources
key objectives of palliative care
The aim of palliative care is to help you to have a good quality of life – this includes being as well and active as possible in the time you have left. It can involve: managing physical symptoms such as pain. emotional, spiritual and psychological suppor
define euthanasia
Euthanasia is the act of deliberately ending a person’s life to relieve suffering.
UK stance on euthanasia
Euthanasia is a crime under English law, carrying a maximum penalty of life in jail, and assisted suicide 14 years.
The only exception is “passive euthanasia”, which is where treatment that might extend someone’s life is withdrawn - such as a life machine being turned off.
For terminally ill patients in the UK, the only alternatives are hospice care or refusing treatment, which mentally capable patients have the right to do.
