S5_Ethical Principles Flashcards
5 Statutory Principles of Mental Capacity Act
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Assume a person has capacity unless the opposite is proven.
2.** Take all practicable steps to help** a person make their own decision. - A person has the right to make an unwise decision.
- Always act in the person’s best interest (B.I.).
- Choose the less restrictive option.
Ethical Principles in Palliative Care
Autonomy –> Informed consent
Justice –> Treatment of individuals, distribution of resources
Beneficence –> Do good
Non-maleficence –> Do no harm
Jonsen’s Four Box Approach
1) Medical Indications
(Principles of Beneficence)
(Principles of non-maleficence)
2) Patient’s or Proxy Preferences
(Respect for Autonomy)
3) Quality of Life
(Principles of Beneficence)
(Principles of non-maleficence)
(Principles of Respect for autonomy)
4) Contextual Features
(Principles of justice)
AMD
3 conditions to check the AMD registry
If the NOK do not agree to a DNR prder in an incompetent patient,
an AMD search should be made with the AMD registry when the following 3 conditions have been met:
(1) P/t suffering from T.I.
(2) P/t requires extraordinary life-sustaining treatment
(3) P/t is unconscious or incapable of expressing rational judgement
LPA
Legal document.
Check with patient (donor)’s legal representative in health &/or financial matters.
ACP
Non- legal document dictating patient’s wishes and treatment plans.
3 types of ACP
- General ACP
- Disease-Specific ACp
- Preferred Plan of Care (PPoc) ACP
DNR
DNR is a medical order to withhold CPR (cardiopulmonary resuscitation).
The DNR order should only refer to the withholding of CPR, and not the withdrawl of monitoring, drugs, nutrition and fluids which are covered by the determination of the extent of care.
Determining Mental Capacity
2 Stage test
Does the p/t have an impairment affecting / disturbing the functioning of the mind/ brain?
1) Can the p/t understand?
2) Can the p/t retain information?
3) Can the p/t communicate his/her wishes?
4) Can the p/t make decision?
