Please enable JavaScript.
Coggle requires JavaScript to display documents.
Withdrawel of Life-sustaining Treatment - Coggle Diagram
Withdrawel of Life-sustaining Treatment
When
Death inevitable
Advanced directive
Worsening with > 3 organ failure despite active management
Why
GMC ethical principles
Equalities and human rights
Presumption in favour of prolonging life
Presumption of capacity
Maximising capacity
Best interests
Factors
Prognostic information
Input from specialists
Involve relative to gian perspective on patients wishes
Second opinion
What problems
Disagreement in medical profession
Second opinions
MDT
Discord with family
VALUE
Value statements
Acknowledge emtions
Listen
Understand
Elicit
Patient requests doscontinuation
Outcome changes
Doctrine of double effect
Intended benefits
Foreseeable but unintended side effect
Defintion of palliative care
Increase quality of life of patients and families
Life threatening illness
Biopsychosocial and spiritual needs
How
Patient centred goals
Symptomatic management
Envirnment
Family
Patient
Stop unneccesary procedures
Stop unnecessary medications
Stopping unneccesary monitoring
Positioning
Medical
Pain
Morphine
Sedation
Midazolam
Delerium
Haloperidol
N+V
Levomapromazine
Secretions
Hyoscine
Organ support
RRT
Low level of distress
Mechnical ventilation
Pre-emtive sedation
Inotropes
Low risk of distress
Extubation