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’
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
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“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
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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
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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
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Connectivity and Cyber Seniors
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Palliative Home Visits are the Future
“What I fear the most – what really terrifies me – is being short of breath and not being able to swallow.” So said the husband of his dying wife. This is terrifying to me, too, so I listened closely to the response given by Palliative Care physician, Dr Sandy...