Palliative care ethics Flashcards
What is palliative care?
medical care
tries to reduce Sx severity
rather than provide a cure or stop disease progression
Should improve QoL in patients and families facing terminal illness
relief of suffering
What is it important to consider in the switch from curative to palliative care?
hard to know when this transition occurs
decision may cause anxiety and anger
may be seen as failure of Rx
not always based on clinical futility
but maybe curative Rx is no longer in patient’s best interest
Different role for doctors if patient has capacity or not
if not, then likely will go to ethics board
What are the main components of “a good death?”
- management of pain and Sx
- clear decision making
- preparation for death
- completion/closure
- affirmation of whole person
- contributing to others
What is suicide?
death caused by self-directed injurious behaviour with intent to die as a result of said behaviour
What is assisted suicide?
deliberately assisting or encouraging a person to kill themselves
What is euthanasia?
literally translated to: A good death
deliberately ending a person’s life for their benefit
e.g. to relieve suffering
What is meant by an ACTIVE action in euthanasia?
providing a life-terminating medication
e.g. actively promoting life-ending
What is meant by a PASSIVE action in euthanasia?
withholding curative medication or Rx
How do voluntary and non-voluntary death differ?
voluntary: act or omission that leads to the patient’s death at the patients own request
non-voluntary: act or omission that leads to the patient’s death without the consent or objection of the patient
What are the 2 main types of euthanasia?
active
passive
What is involuntary euthanasia?
person is killed against their expressed wishes
would be considered as murder legally
Which legal statutes inform on the legality of suicide and euthanasia?
Mental Capacity Act (2005): patients with capacity can refuse life-saving treatment
Human Rights Act (1998): protects the right to freedom from inhuman and degrading treatment and the right to private and family life
Suicide Act (1961): suicide is not unlawful
What is the law regarding suicide?
suicide is no unlawful
debatable whether it is ethical
What is the doctrine of doubt effect?
States that if a doctor prescribes medication with INTENTION of relieving pain, then it is not seen as euthanasia
(doctor may have foreseen that this will also shorten the patient’s life)
However, if the intention was to kill patient (even if done to relieve pain), then it would be euthanasia and therefore illegal
What stipulations are to be met if an action is permissible under the ‘Doctrine of Double Effect?’
- the nature of the act is not bad
- at least one of the act’s consequences is good
- at least one of the act’s consequences is bad
- there is a sufficiently serious reason for allowing the bad consequence to occur
the bad consequence is not a means to the good consequence - the agent foresees the bad consequence but intends the good consequence
