In Favour of Medical Dissensus: Why We Should Agree to Disagree About End‐of‐Life Decisions. Resources from the UK Clinical Ethics Network.NHS England – Leadership Alliance for the Care of Dying People.Do Not Attempt CPR – Legal updates from the University of Southampton.Faculty of Intensive Care Medicine and Intensive Care Society – Guidelines for the Provision of Intensive Care Services.End-of-life decisions (views of the British Medical Association).Resuscitation Council (UK) – DNACPR model forms.Resuscitation Council (UK), British Medical Association and Royal College of Nursing – CPR decision making.General Medical Council (GMC) – Guidance on end of life care and decision making.MyDeath,MyDecision - An online tool for developing an advance decision and advance statement.Compassion in Dying - A UK charity that helps patients and their doctors draw up Advance Care Plans and other matters.Resuscitation policy should focus on the patient, not the decision. Fritz Zoë, Slowther Anne-Marie, Perkins Gavin D.ReSPECT can be complementary to a wider process of advance/anticipatory care planning. It provides health and care professionals responding to that emergency with a summary of recommendations to help them to make immediate decisions about that person’s care and treatment. ReSPECT - Recommended Summary Plan for Emergency Care and Treatment - ReSPECT is a process that creates personalised recommendations for a person’s clinical care in a future emergency in which they are unable to make or express choices.Other bodies such as medical defence organisations and ethics groups also provide useful information. Professional bodies such as the Intensive Care Society also provide further resources, as do the GMC and BMA. Links to key resources are provided below to key guidance from the General Medical Council (GMC), The Resuscitation Council UK and British Medical association (BMA). A summary of recent legal cases relating to the Mental Capacity Act UK Supreme Court Blog - Aintree University Hospitals NHS Foundation Trust v James UKSC 67.The following links explore recent cases involving end of life care and withdrawal of therapies in patients lacking capacity: The courts may be required as a last resort. The goal should be to reach consensus with patients or their families as sensitively as possible, providing second opinions wherever practical, and using mediation services and legal advice if necessary. However the specific wishes of patients and families should not override the views of clinical teams where the risks, burdens and benefits of a treatment outweigh any likely benefit. For patients who lack capacity, all decisions should be taken in the fullest sense of their best interest, and take into account any known views of the patient and their family. Recent guidance has emphasized that competent patients must be involved in decisions to withdraw care, or withhold lifesaving treatments such as CPR, even if attempts are likely to be futile. Questions of what constitutes futility, the extent to which patients wishes should prevail over clinicians, and how far patients should be involved in decisions have all caused particular difficulty. In practice these decisions and associated discussions may be very difficult for clinicians and distressing for patients and their families. where there is a prior advance decision that is valid and applicable.where they have been refused by a competent patient.where they are unlikely to provide benefit.Medical treatments should not be provided to patients:
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