GET THE SLIDES
- Want to follow patient's best interests, not the self-serving family
- Sometimes hard because the patient might be vegetative
- E.g. someone in vegetative state, husband wanted her to die, family wanted her to live.
- She can breathe, has heartbeat etc. She just has a nasogastric tube for food.
- American pro-life extremists offer husband heaps of money; people try to make it illegal to remove NGT
- 1) Who decides what is in the patient's best interests? Doctors may disagree, etc etc
- 2) Is NGT a medical procedure or is it a social/compassion thing?
- Another case: EEG shows someone has no cortical function.
- Treatment can be withdrawn by supreme court irrespective of family's objections.
- Important: futility of treatment - weigh up burdens and benefits of treatments
- Many argue it's not in best interests to be vegetative
- Courts tend to support clinical judgement
- Different US states have various different rules about when you can let someone die
- Advanced care directives
- You have to be in a vegetative state for 6 months for it to be considered chronic
- Judges have said you need to continue treatment until after 6 months
- Advanced care directives can help keep cases outside the courts.
- Be aware of prognoses, that may change with time as new medical knowledge appears.
- Families can go against advance care directives unless all the medical weight supports treatment