Consent, 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’
A beautiful death
“My mother was ‘dying’ for about 10 years – with her sickness, she seemed often on the brink of death, and then she’d rally. We’d all said our goodbyes a number of times. But on the day she actually died, my father was in her bed, his arm around her, holding on to...
Taking Palliative Care Mainstream with the help of ePatients
Charlie Blotner, 21-year old ePatient and co-founder of the tweetchat for those with brain tumours #btsm. In learning more about Palliative Care, it just made sense that it should be part of standard services. Alas, not: If you’ve seen one #palliative care program, you’ve seen . . . one palliative care program – Jill Mendlen
Dr. Michael Fratkin is an enabler
“Most of my healing has little to do with medicine.” “My approach has more to do with being there, listening and helping people with a different approach.” Fratkin, entrepreneur creator of Resolution Care, is a Palliative doctor
Extreme Measures: Dr Jessica Zitter on a Palliative mission
“I’m going to call 911: a doctor is torturing a patient.” So said Nurse Pat Murphy to Dr Jessica Zitter – just as Zitter was about to plunge a syringe into the neck of a patient with a host of health issues. Tho the 911 call wasn't made, it was a turning point for...
Vial of LIFE
What is the Vial of LIFE Program It may sound like the fountain of youth, or miracle life-saver in a vial. It is neither. Instead, it’s information about your health care and wishes, stored in your fridge with a fridge sticker to announce its presence. LIFE stands for Lifesaving Information for Emergencies The Vial of LIFE sticker on your fridge alerts Emergency Response Teams (EMS) Paramedics and other health care providers who may come to your home
Dementia – more than memory loss: it’s a broken brain
Dementia: Communication, hard-to-manage behaviours and safety A much needed re-framing of Dementia from Alberta Health Services clinical nurse specialists, Jennette Coats and Loralee Fox, who embrace care and caring for those with ‘broken brains’. I sat in on their...
Coalition for Compassionate Care Summit with ePatients
ePatients: Engaged and Empowered and Invited The Coalition for Compassionate Care of California (CCCC) promotes high-quality, compassionate care for everyone who is seriously ill or nearing the end of life. What a human-centered, patient-centered goal. And now,...
Advance Care Planning: Women’s College Hospital and Kathy Kastner
National Advance Care Planning Day sees Women's College Hospital as leaders: bringing the first consumer-created End-of-Life website to Family Doctors. TORONTO APRIL 16...Women's College Hospital (WCH) is the first to embark on a project with Family Doctors and...
High Risk Surgery: Best Case, Worst Case
Decision tool to help understand chances of dying after high risk surgery “People worry about ‘dying poorly’, so one of the reasons for agreeing to surgery is the mistaken belief they’ll likely die - peacefully - in the Operating Room. This rarely happens.” Dr...
Connectivity and Cyber Seniors
Cyber Seniors: the growing internet demographic For the legion of cyber seniors, age 60-90 who rely on internet access to stay connected, it will come as no surprise that I put forward, in a recent tv panel, ‘internet for free’ for the elderly and low income as a...
A doctor is surrounded by people who are sick, discouraged, afraid, embittered, dying – but also courageous, loving, wise, compassionate and alive.
