Making tough decisions at the end of life

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McCarthy, Joan
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In end-of-life situations, health professionals, patients and families must often make difficult decisions in tense, demanding, emotionally fraught and constrained circumstances. Every day, caring for dying patients, nurses and doctors find themselves faced with moral questions and challenges: What is good care in this case? How can I be a good nurse or doctor? What do I say if this patient asks “Am I dying?” Should we start or stop treatments such as dialysis, ventilation or nutrition and hydration? Will treatment prolong life or hasten death? Should I document a Do Not Attempt Resuscitation Order (DNAR)? What should I do if there is no DNAR order? How much involvement should this patient and/or family have? How far do my professional and legal responsibilities extend? With medical technology we gain greater control over how and when we die. With greater control comes greater responsibility for the range of complex decisions medical technology makes available. The recently launched Ethical Framework for End-of-Life Care (McCarthy, Donnelly, Dooley, Campbell, Smith [2010] Dublin: Irish Hospice Foundation) is a set of educational resources that offers a constructive response to the challenges of such decision-making. The overall aim of the Framework is to foster and support ethically and legally sound clinical practice in end-of-life treatment and care in Irish hospitals and healthcare settings. It has emerged as part of a larger initiative, the Hospice Friendly Hospitals Programme (HfHP), of the Irish Hospice Foundation in collaboration with the Health Services Executive and with the support of The Atlantic Philanthropies.
End-of-life , End-of-life care , Ethical Framework for End-of-Life Care , Healthcare ethics
McCarthy J. (2011) 'Making Tough Decisions at the End of Life', FEASA: Newsletter of the All-Ireland Gerontological Nurses Association, 1(3), pp. 21-22.
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© 2011 The Author