Tuesday, July 5, 2016

Order of decision making

Ideally, a doctor discusses the available options of treatment with the patient, the patient makes a decision and informed consent is obtained.

However, this may not be possible on every occasion and it is the physician's responsibility to ensure that a decision is made that would be what the patient would have wanted (if the patient does not have the capacity to make the decision himself/herself).



These diagrams outline the order that a medical practitioner is to follow given the situation that he/she is presented with.

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Healthcare proxy and living will are documents (Advanced directives) that convey the wishes of the patient.
A healthcare proxy is basically a list of procedures that the patient can select or reject. An agent is also included in the same.
A living will is just like a will (of the financial sort) but it deals with the patients wishes (that are clearly stated)  regarding medical care.



This is could be a tricky path riddled with angry family members and potential lawsuits but we must do what the patient would have wanted. If that is not clear then, we must seek a neutral decision  maker (Ethics committee or a Court of Law, in that order) that would choose what is in the best interest of the patient.

It is always better if the patient has prepared advanced directives. However the patient can overrule them (at any moment) if he/she has the capacity to do so.

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