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Common ethical issues in anaesthesia (Pain, dying and Advanced Care…
Common ethical issues in anaesthesia
Pain, dying and Advanced Care Planning
ANZCA supports concept of death with dignity and comfort (must minimise risk of patients seeking to end life because of suffering)
Respect competent patients right to decline or withdraw treatment
Pain relief - unrelieved pain has sever physical, psychological effects
Advanced care planning
Means for patients to record their end of life values and preferences to guide when they are not able to make decisions
Number of stages: Informing patient, eliciting preferences, identifying surrogate decision maker
In anaesthesia: helps to decide course of action and acceptable outcomes for patients who may now have lost competence
Prevention of futile care
Futile = treatment that gives no chance of meaningful prolongation of survival (or very brief delay)
Should discuss CPR, ICU, DNR orders
Euthanasia not acceptable
Legislation - clinicians under no moral obligation to attempt medical treatment that could cause harm or would provide no benefit
Moral objection to procedure by Fellow
Should inform patient of the objection and refer her to another health practitioner in same profession
Must be: professional, non-judgemental, allow informed choices
Legislation - Abortion Law Reform Act (Victoria, 2008)
Organ donation and transplantation
Discussion of option of donation is professional responsibility of the intensivist
Barriers:
Fears medical person will withdraw treatment early if they know someone is a registered donor