Week 1 - F - Ethics of End of life care Flashcards
A competent patient can refuse any treatment, make an advance refusal of treatment (ART) or appoint a proxy decision maker What does an advance refusal of treatment include? (think most of the old people at the care home)
ART - includes Do not attempt cardiopulmonary resucitation (DNACPR aka DNR)
Advance refusal of treatment has some requirements It must state that the decision applies even if life is at risk and what are the other three factors involved?
It must be written, it must be signed and it must be witnessed
What are the 4 requirements for an advance refusal of treatment? (ART)
Must state that the decision applies even if life is at risk Must be in writing, must be signed and there must be a witness
If the patient no longer has capacity to refuse treatment or make decisions, what can you check?
Check to see if the patient has made arrangements for a legal proxy to make decisions (legal power of attorney to someone else) Check to see if the patent has made legally binding advance decision making
If there is no proxy or advance directive in a patient who no longer has capacity, what should be done?
Consult with close to the patient and the healthcare team Ultimately do what is best for the patient
In a patient who no longer has capacity for decision making and has no legal proxy or advance directive, what is it important to consider when consulting with the close family and healthcare?
Important to consider what the patient would have wanted and not to make assumptions based on what your loved ones would have wanted
When would it be acceptable to withhold or withdraw life prolonging (safing) treatment?
It is acceptable if the treatment is futile or it is best for the patient
Giving treatment that might cause patient’s death is only acceptable under what act?
Acceptable under the Doctrine of Double Effect Act (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 What is an example of the doctrine of double effect?
An example is given morphine in end of life care to leviate the pain
Is the UK currently an opt in or opt ut organ donation system?
It is an opt-in so people are required to opt - in if their organs are to be donated after death (As of autumn 2020, Scotland will be an opt-out organ donation country - ie Under the new law, all adults in Scotland will be considered to be potential organ donors when they die unless they had recorded a decision not to donate)
