Advance care planning in palliative care: a national survey of health professionals and service managers

Australian Health Review, published online 22 January 2015
Authors: Marcus Sellars, William Silvester, Malcolm Masso and Claire E. Johnson
“ACP is increasingly recognised as an important part of care of people in hospital and community settings. However, currently there is no empirical evidence about the national uptake and quality of ACP in palliative care settings specifically.”
Find abstract here. See also ‘Palliative care health professionals’ experiences of caring for patients with advance care directives‘.

Hospitals Wrestle With Extent of Ebola Treatment

WSJ, 31 October 2014
Author: Stephanie Armour
“U.S. hospitals are grappling with whether to withhold aggressive treatments from Ebola patients to avoid further exposing doctors and nurses to the virus. Some facilities have decided they will forgo cardiopulmonary resuscitation or may opt not to pursue invasive surgical procedures on deteriorating Ebola patients.”
Find article here.

Continuing or forgoing treatment at the end of life? Preferences of the general public and people with an advance directive

J Med Ethics doi:10.1136/medethics-2013-101544
Authors:  Matthijs P S van Wijmen, H Roeline W Pasman, Guy A M Widdershoven, Bregje D Onwuteaka-Philipsen,
Background We studied preferences on continuing or forgoing different types of treatments at the end of life in two groups: the general public and people with an advance directive (AD). Furthermore, we studied factors associated with these preferences and whether people’s preferences concurred with the content of their AD.”
Find abstract here.

Advance consent, critical interests and dementia research

J Med Ethics doi:10.1136/medethics-2014-102024
Author: Tom Buller
“Although advance directives have become a familiar instrument within the context of treatment, there has been minimal support for their expansion into the context of research. In this paper I argue that the principle of precedent autonomy that grants a competent person the right to refuse life-sustaining treatment when later incompetent, also grants a competent person the right to consent to research that is greater than minimal risk.”
Find abstract here.

Revisiting advance decision-making under the Mental Capacity Ac 2005: A tale of mixed messages

Med Law Rev (2014) doi: 10.1093/medlaw/fwu021
Author: Rob Heywood
“Whilst most of the existing literature relating to advance decisions has focused on philosophical questions, this article reflects on the significant legal developments that have occurred since the introduction of the Mental Capacity Act 2005. The article provides a critique of the controversial issues which have emerged within contemporary case law. The focus of the discussion centres on capacity, the interpretation of the safeguards, and the bias towards preservation of life.”
Find abstract here.

Precedent autonomy should be respected in life-sustaining treatment decisions

J Med Ethics Published Online: 24 February 2014

Authors: Allison Leslie Hebron, Summer McGee

“In the 2011 landmark case of W v M, the English Court of Protection ruled that it was unlawful to withdraw artificial nutrition and hydration from a woman (M) who had been in a minimally conscious state for 8?years.1 By relying on the sanctity of life principle, the Court’s ruling clearly favours the preservation of life in the absence of an advance directive regardless of a person’s previously, albeit verbally, expressed wishes…”

Find article here.

Palliative and end of life care Priority Setting Partnership

James Lind Alliance, Palliative and end of life care Priority Setting Partnership

What are the aims of the partnership?

The partnership is bringing together organisations interested in palliative and end of life care. The aim is to consult people likely to be in the last years of life, current and bereaved carers and families, and healthcare professionals about what questions they believe need answering through research.

Together we will prioritise these research needs to ensure that future research improves the care and support that can be provided for those in the last years of life, their carers and families…”

Find website here.

Prolonged disorders of consciousness: national clinical guidelines

Royal College of Physicians 12 December 2013

National clinical guidelines on the care of people in a vegetative or minimally conscious state, following severe brain injury

These long-awaited guidelines will be a major contribution to clinical and ethical standards of care for this group of patients, not only in the UK but internationally. For England and Wales, they provide much needed clarity on legal decision-making…

The guidelines were developed by a panel of experts in the field, who have organised complicated and wide-ranging information into six coherent sections:

1 Defining criteria and terminology
2 Assessment, diagnosis and monitoring
3 Acute to longer-term management
4 Ethical and medico-legal issues
5 End-of-life issues
6 Service organisation and commissioning

Each section is followed by a set of clear recommendations…”

Find guidelines here.

Difficult but necessary conversations — the case for advance care planning

Med J Aust 2013; 199 (10): 662-666. 18 November 2013

Authors: Ian A Scott, Geoffrey K Mitchell, Elizabeth J Reymond and Michael P Daly

“…Regrettably, considerable suffering as well as dissatisfaction with and overuse of health care result from a mismatch between the needs of chronically ill patients and current practice norms. Advance care planning (ACP) provides a means of ameliorating this mismatch but is yet to be embedded in routine clinical practice or public consciousness…”

Find article here.

When ethical reform became law: the constitutional concerns raised by recent legislation in Taiwan

J Med Ethics Published online 16 October 2013

Author: Yi-Chen Su

“…Ethics debates on medical issues seldom involve the constitution. Nonetheless, the constitution must be considered when advocates seek to enforce their views on medical ethics through state actions such as legislation. The medical community in Taiwan persuaded the government to remove the arguably burdensome legal procedure required for the termination of incompetent patients’ life-sustaining treatment based on futility and waste.2 However, the new law, as the embodiment of the medical community’s collective view, has raised constitutional concerns…”

Find article here.