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legal

Legal issues in end-of-life care 2: consent and decision-making

02 November 2020
Features
02 November 2020
Volume 12 · Issue 11

Abstract

Paramedics are legally and professionally obliged to uphold their patients' right to dignity, respect and autonomy—and this includes the general requirement to obtain their consent before proceeding with any intervention. The first instalment of this two-part article considered the challenges that this might present to the paramedic. This second article develops this theme and further explores the legal framework underpinning the decision-making process when caring for a patient approaching the end of life. It also examines issues around consent and mental capacity in more depth and addresses matters such as such as advance decisions to refuse treatment (ADRT) and do not attempt cardio-pulmonary resuscitation (DNACPR) decisions.

After completing this module, the paramedic will be able to:

This is the second of a two-part article on care of the patient who is dying or at risk of dying. The previous instalment recognised that care of such patients is a fundamental part of frontline paramedics' professional role (Taylor and Brogan, 2020). Paramedics will be called to attend patients and their families at one of the most difficult times in their lives, and will need to uphold their duty of care to the patient by making decisions that have sound a clinical, professional and legal basis (Cassidy v Ministry of Health, 1951; Health and Care Professions Council (HCPC), 2016).

While individual circumstances differ, the outcome of these decisions can have profound implications; for example, a decision to discontinue active, life-preserving treatment and shifting the focus of care to symptom palliation to enable the patient to die with dignity.

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