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Some time ago, I saw a pt with severe untreated suffering at #EOL alongside aggressive & unproven life-prolonging interventions. When I asked the medical team, they said they were doing “what the family wanted.”

Sharing some of my thoughts about this below 👇🏾👇🏾👇🏾
1/ Rejecting paternalism does not imply that we take ourselves out of the decision making process altogether. We should always work together with our pts & families rather than just “doing what they want.”

#hpm #hapc #bioethics
2/ We should move towards a “deliberative” rather than an “informative” model of decision making. Pts should share values/expectations & we propose medical treatments. It is crucial for all HCPs to have better training on having #goalsofcare conversations.

#hpm #hapc #bioethics
3/ Our fundamental duty remains to “do no harm.” It is highly unethical to offer treatments that would cause more suffering or are not indicated, even if the family “wanted it.”

#hpm #hapc #bioethics
4/ Important to remember consent is not required to NOT do something to someone. There is NO default treatment that is indicated for everyone all the time. Hence, no obligation to start treatments which increase harm & suffering and are unproven to work.

#hpm #hapc #bioethics
5/ In a non-emergent circumstance at #EOL, prior to taking action, would recommend taking a pause & reflecting on the treatment plan. Could always consult other colleagues, including the #palliativecare team, ICU physician, ethicist, and/or social worker!

#hpm #hapc #bioethics
6/ Trust & rapport are critical when trying to make decisions together with a pt & family. If you can’t relate to the pt or family, it may become very challenging to collaborate on #EOL decision making. Be a human being first, technician later!

#hpm #hapc #goalsofcare
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