In Canadian law, the capable patient always decides. Who decides?Ī seemingly straight forward question, however, it can be a source of concern when it comes to making treatment decisions. Upholding the aspects of life that a patient truly values in the context of their medical disease should supersede the pursuit of any intervention that has potential to be detrimental to their well-being. However, in Palliative Care, the emphasis is truly on maximizing symptom control to reduce suffering, in the hope of enhancing one’s quality of life. Often times, families want their loved ones to “keep hanging on” and believe it is necessary to pursue every possible intervention that has a slight chance of extending their lives. It is important that the patient decides how long he or she would like to pursue life prolonging treatments, in the context of his or her physical, psychosocial, and spiritual suffering. There is always a balancing act when a patient pursues active medical treatments that will sustain life while ensuring that his or her comfort is not compromised. Only the patient can decide what is an acceptable quality of life for him or herself. This refers to one’s well-being which includes all the aspects of life that make life meaningful to that person. While life prolongation may be part of a patient’s initial goals of care, there comes a tipping point where it becomes imperative to consider the state of one’s quality of life. This is a natural reaction when confronted with one’s mortality. When confronted by a life-limiting diagnosis, most patients reflexively utter the words, “But I want to live”. This guide serves as a brief overview of some commonly encountered moral themes in Palliative Care given the unique complexity of each patient’s illness and experience of dying, it represents a small spectrum of scenarios that might arise. In contemporary medical bioethics, four major principles are often called upon to assist patients, families, and their physicians in making meaningful and morally acceptable choices with respect to care at the end of life: the Hippocratic principles of non-maleficence and beneficence, as well as the more recently developed principles of autonomy and justice. Patients, families and clinicians may face a myriad of ethical dilemmas when providing end-of-life care: Complex medical scenarios when deciding to withdraw life support interventions when to use artificial hydration and nutrition at the end of life to issues related truth telling and disclosure. In the effort to survive longer, patients, families and clinical staff are often confronted with difficult choices regarding medical advances that may inadvertently prolong suffering and the dying process rather than bring healing and recovery. The patient, his or her family, and the healthcare team are often faced with challenging scenarios in which there are no apparent “right” answers. The field of health and health care raises numerous ethical concerns, related to, for example, health care delivery, professional integrity, data handling, use of human subjects in research, and the application of new techniques, such as gene manipulation. The World Health Organization provides the following definition for ethics:Įthics is concerned with moral principles, values and standards of conduct. Canadian Network Of Palliative Care For Children Open Child PagesĬategory: Ethics and norms Sunnybrook Ethics Centre: Ethics Pocket Tool Ethics at the End of Life.Quality End-of-life Care Coalition of Canada (QELCCC) Open Child Pages.Saying Goodbye Concert Open Child Pages.Canadian Compassionate Companies Open Child Pages.Advance Care Planning in Canada Open Child Pages.World Compassionate Communities Day Open Child Pages.National Caregiver Day Open Child Pages.Hike for Hospice Palliative Care Open Child Pages.National Grief and Bereavement Day Open Child Pages.National Children’s Hospice Palliative Care Day Open Child Pages.Advance Care Planning Day Open Child Pages.National Hospice Palliative Care Week Open Child Pages.
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