Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where
we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!
This is a special update, as two weeks ago, the Ontario
College of Physicians and Surgeons gave final approval to its Planning for and Providing Quality End-of-Life Care policy.
Professor Thaddeus Pope, who is a medical futility lawyer has posted these news on his blog http://medicalfutility.blogspot.com only in the last 24 hours!
Finally, the rights
of families in Intensive Care when it comes to decision making in real or perceived end of life situations are heard and finally doctors in Intensive Care need to consult with families before issuing an NFR(not for resuscitation) or DNR(Do not resuscitate) order!
Recommended resources:
Unfortunately this is only in Canada and only in the province of Ontario, however this is a start and hopefully other states in the US and Canada will follow!
I also hope that laws and perceptions will change in the UK and Australia, where way too much power lies with the Intensive Care to
issue NFR(not for resuscitation) or DNR(Do not resuscitate) orders!
There is way too much of the perception in Intensive Care that only Doctors know "what is best" or "what is in the best interest" of a critically ill Patient in Intensive Care, especially in real or perceived end of
life situations!
Lets get into the meat of what Professor Pope blogged about yesterday on his blog
http://medicalfutility.blogspot.com
Two weeks ago, the Ontario College of Physicians and Surgeons gave final approval to its Planning for and Providing Quality End-of-Life Care policy.
Section 5.2 concerns "Potentially Life-Saving and Life-Sustaining Treatment." Three
paragraphs are of note:
"A decision regarding a no-CPR order cannot be made unilaterally by the physician. Where a physician is of the opinion that CPR should not be provided for a patient and that a no-CPR order should be written in the patient’s record, the College requires physicians to discuss this with the patient and/or substitute decision-maker at the earliest and most
appropriate opportunity, and to explain why CPR is not being proposed. This discussion must occur before a no-CPR order can be written."
"If the patient or substitute decision-maker disagrees and insists that CPR be provided,physicians must engage in the conflict resolution process as outlined in Section 8 of this policy which may include an application to the Consent and Capacity
Board. Physicians must allow the patient or substitute decision-maker a reasonable amount of time to disagree before a no-CPR order can be written."
"While the conflict resolution process is underway, if an event requiring CPR occurs, physicians must provide CPR. In so doing, physicians must act in good faith and use their professional judgment to determine how long to continue providing
CPR."
Over at the Healthcare Consent Quality Collaborative, they are "scratching their
heads trying to make sense of the actions that are now required of Ontario physicians." In particular, the final paragraph instructs physicians to "begin CPR (i.e. disregard their clinical judgment about the ineffectiveness of such an action), but then only provide CPR for a period of time considered appropriate by use of the same professional judgment."
PS: I have also interviewed Professor
Pope on two separate occasions on my podcast. You can listen to the interviews here
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friend
Patrik Hutzel
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Patrik Hutzel
Critical Care Nurse
Founder& Editor
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