The aim of this guideline is to inform health and social care professionals on how best to manage advance care planning (ACP) in clinical practice. At the core of current health and social care are efforts to maximise individuals’ autonomy, promote patient-centred care, offer choice and the right to decide one’s own treatment or care. This can be difficult to achieve when an individual has lost capacity – the ability to make their own, informed decision. ACP is one method of enhancing autonomy, not only where an individual has lost capacity, but also by focussing discussion on the individual’s values and preferences throughout the time they are in contact with health or social care professionals. Whilst ACP has been used for some time in North America, there has been relatively little experience in the use of ACP in the UK. This set of concise evidence-based guidelines has therefore been prepared to guide practitioners.
This site explains how the law now allows people to make decisions to refuse treatments including those that sustain life. Many people want to achieve a natural and dignified death, this is one way to help achieve it. This is a free and non-profit NHS website. We suggest people enter the site using the relevent menu section (above). Many people benefit from looking at both sections.
More than 700,000 people in the UK currently suffer from dementia, and nearly 500,000 friends and family members act as carers for people with dementia. Our rapidly ageing population means that these numbers are likely to double in the next forty years. While we are getting to understand better the causes of the disease, and diagnostic and treatment options are improving, we are still a long way from prevention or cure. Meanwhile, these people and their families, healthcare staff and care workers face difficult ethical dilemmas on a day-to-day basis. An exploratory workshop was held in March 2007, and the Nuffield Council set up a Working Party in December 2007 to examine the ethical issues raised by dementia. Following a public consultation and meetings with stakeholders including people with dementia, carers, health professionals and other members of the public, a report with recommendations for policy makers was published on 1st October 2009.
25th July 2013: The Mental Capacity Act (MCA) made Advance Decisions to refuse treatment legally binding in statutory law in 2005, and Compassion in Dying has been providing free information on end of life and Advance Decision forms since 2010. A new study, which looked at in excess of 200 calls to Compassion in Dying, found that a major barrier to patients exercising choice was doctors’ failure to engage with patients about their Advance Decision and the lack of systems in place to record them. Two callers reported considering a ‘DNR tattoo’ as a way of addressing this problem. The study also found women (84% of callers) are more likely than men (16%) to make their wishes known at the end of life. Professor Sue Wilkinson, author of the report and Professor of Feminist and Health Studies in the Department of Social Sciences at Loughborough University said: “This study has led to a number of recommendations for Compassion in Dying, and more broadly for the integration of Adva...
This is an application made by the NHS Foundation Trust in the Court of Protection for a raft of declarations in relation to a young man, M, who was born on 19th June 1990 and so approaches his 23rd birthday. M was tragically born with a congenital abnormality of the brain called holoprosencephaly ("HPE"). It is common ground that in the period of time since 2010 M's condition has significantly deteriorated. He is now seriously malnourished and, in the view of both the treating physicians and independent experts instructed for the purposes of this hearing, reaching the end of his life. The painful and difficult issues now to be faced by M's family, the medical team that have cared for him so diligently over many years, and ultimately this court, is to what extent should M be treated in Intensive Care or be given cardio-pulmonary resuscitation ("CPR") in the event that there is a further deterioration in his condition. There is no question of M having the capacity himself to make...