1:3. Ethics of End of Life Care/Tissue Donation Flashcards Preview

Ophthalmology > 1:3. Ethics of End of Life Care/Tissue Donation > Flashcards

Flashcards in 1:3. Ethics of End of Life Care/Tissue Donation Deck (19)
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1

Competent patients can refuse treatment
T/F?

True

2

Competent patients can demand treatment
T/F?

False

3

Competent patients can refuse treatment in advance
T/F?

True

4

Competent patients can appoint a proxy decision maker
T/F?

True

5

What is advance refusal of treatment?

This is refusing treatment that may be needed in the future
Includes DNACPR/DNR

6

What is DNR/DNACPR?

This is 'Do Not Resuscitate' or 'Do Not Attempt Cardiopulmonary Resuscitation"
This is an advanced directive not to attempt resuscitation when patient's life is at risk

7

What must a DNR have to be legal?

- Must state that this applies even if patient's life is at risk
- Must be in writing
- Must be signed
- Must be witnessed

8

Describe end of life decisions:
- Patient has capacity?

Patient gets to decide
Decision is made with patient and multi-disciplinary team

9

Describe end of life decisions:
- Patient has no capacity

Check for proxy (power of attorney) or advanced directive

If there are neither of these things:
- Consult those close to patient
- Consult health care team
- Do what is best for the patient
- Find out what the patient would have wanted if they could tell you

10

When is it acceptable to withdraw/withold life saving treatment?

- If competent patient requests it
- If it is best for the patient
- If the treatment is futile

11

Describe the Tony Bland case?

1st patient to be legally allowed to die due to withdrawal of treatment
Severe brain damage following Hillsborough accident
No signs of life
Decision by courts to allow treatment withdrawal

12

When is it acceptable to give treatment that may cause death?

Under the Doctrine of Double Effect
This states that some actions that may be wrong and cause serious harm are permissible if they have the side effect of promoting some good end
Death is not the main cause of the treatment but a secondary side effect
Eg: Morphine for pain relief in palliative care

13

Describe the legality of assisted suicide?

Illegal in the UK
Includes physician assisted suicide
Legal in some places

14

What act involves tissue donation in Scotland?

Human Tissue Act (Scotland) 2006

15

Describe two basic ethical rules of tissue donation?

- All tissue used appropriately
- Patients must consent for use of their tissues for anything other than their own treatment or investigation

16

How do you consent to tissue donation before death?

Sign up to become an organ donor (Eg: On drivers license)

17

How do you consent for tissue donation if the patient is close to death and unable to consent?

Speak to those close to the patient

18

Describe tissue donation in the UK?

Opt-in system
Consent is not assumed
Consent is required for tissue use

19

Describe tissue donation in places that have a different system to the UK?

Opt-out
Consent is assumed unless there is reason to believe otherwise (person has opted out)