Ethical Dilemma - 3
Your patient has decided to “make arrangements
and sort out her affairs” as she knows she is
dying. There is no dispute about her medical condition.
You have suggested that together you could make an
Advance Care Plan. The patient suddenly announces that
she does not want any life sustaining treatment especially
resuscitation when her time comes. The patient says
very clearly and forcefully, “Don’t tell
my family, they don’t want to let me go. Just
give me a form and let me sign it!” You support
the patient completing their own valid and applicable
ADRT and act as their witness.
The family have been waiting outside the room, knowing
that there has probably been this type of discussion.
The patient’s husband asks you, “So what
did she say? You will do everything for her won’t
you?”
How do you respond to the husband knowing that you
have just supported the patient to make a valid and
applicable ADRT?
Discussion
If the request to make an ADRT is valid and the person
has capacity it would be wrong not to support the patient
in making this decision. If the professional is not
able to do this, for what ever reason, they could ask
another person to support the patient. The professional is allowed to be a witness to the
signature of an ADRT. If the patient has clearly refused permission for this
ADRT to be discussed the professional cannot break
confidentiality. Tact and diplomacy should be used
in explaining the situation and any questions the family
may have should be addressed to the patient. It is
the patient’s decision to decide who to tell.
If a valid and applicable ADRT has been made the doctor
has to follow it. |
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