consent _conflictConsent, Conflict and Decision-Makers

For a patient to give consent for a treatment, intervention or procedure, he or she has to: understand what it is and understand what it means.

For example: 96-year old Helen completely understands that she’s going to have a procedure for glaucoma, but when asked to explain what that means to her, and expectations for recovery, she turns to her daughter and says, ‘You explain.’ In this case, she’s not competent to give her consent because she’s lost what’s described as ‘executive functions’. From WebMD

Executive functions work together to help a person achieve goals. Executive functions include the ability to:

  • manage time and attention
  • switch focus
  • plan and organize
  • remember details
  • curb inappropriate speech or behavior
  • integrate past experience with present action

The consent issue complicates End of life decisions that are already a mine-field of conflicts  – amongst siblings and or family members, and often with health care professionals. In each case the reasons are the same:

  • Decisions based on what feels best for the decision-maker – not what’s best for the patient
  • Not ready to ‘let the patient go’

Doctor learns from his mother: the patient

Health care professionals see healthcare differently when it gets personal Dr. David Lee Scher has 25 years of clinical medical experience as cardiologist and cardiac electrophysiologist, hospital department administrator, clinical trial investigator, Chair of the...

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Hunger and thirst: our needs diminish as life ends

Planning for end of life for those with specific medial conditions: Not able to eat or drink “I have conversations every day about food and supplements for frail elderly and even those with early stage dementia.” Dr. Michael Gordon Geriatrician, Ethicist, educator,...

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Dying at home: a return to the way it was.

There’s an explosion of home care needs coming. “With so many wanting to die at home, we need to know what to do as a healthcare team to support that journey through end of life and beyond: the family goes on although the patient is absent in a physical sense.”  ...

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TEDxYorkU: speaking about BestEndings

Exit Laughing: my 12-minute TEDxYorkU talk (Woot!) This TEDtalk is an Ode to End of Life tweeters. I wanted a slide chock full of the tweeps I learn from, admire and look to for their hearts, minds, spirit and sense of humour. Alas this was not to be.

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BestEndings Readers Comment

Comments from BestEndings readers I so appreciate knowing what my readers think! I applaud your frame of mind now and urge you to embrace your quest. As a. 58 yo woman whose mom died about 18 months ago, I wish she had had the courage to plan more. She'd always said...

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A doctor is surrounded by people who are sick, discouraged, afraid, embittered, dying – but also courageous, loving, wise, compassionate and alive.

Dr Bernie Seigal

The Hug Doctor