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Old 05-20-2014
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Arrow Ethics Futile Care

Guys, please help me on this:

Kaplans says that when physician thinks continued treatment is futile but surrogates INSISTS on continued treatment----> TREATMENT SHOULD CONTINUE.

but in Conrads it says the opposite: i quote:

"For example, a 57 year-old woman with cryptogenic cirrhosis is under your
care.septic, hypotensive, not responding to lactulose, She develops Hepatorenal syndrome and has developed uremia.
The family is requesting placement of fistula for dyalisis, what should you tell them?

In this case, there is a clear preterminal condition, you SHOULDNT start dylisis, because in this case dyalisis would only prolong the process, withholding it IS ETHICAL, even if the family is requesting it"

------
how do we handle this topic on step1? if the treatment is futile what is the FINAL DECISION??
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Old 05-21-2014
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Well, even though its futile, in practice, the physician usually tries to follow the wishes of the surrogates BUT he can decide to withdraw any ongoing care and will not be held liable in the court of law.

This is something similar to abortion where in some states, the child doesn't need permission but nevertheless the physician strongly encourage the child to have a discussion with her parents BUT he won't be held liable if he were to continue with the abortion (on the account of her being an emancipated minor.)
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Old 05-21-2014
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Hi pisho...i asked the same question which you have posted her to Dr.steven daugherty(I am friends with him on FB)...This is what he replied...

The key is representing the patient's wishes, not what the family wants. Familys request is meaningless. Second, the dr lays out options and the patient choose. Inthe kaplan case, the family, prenenting the pts wishes want the treatment to continue.

hope this helps
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Old 06-13-2014
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Quote:
Originally Posted by hope2015 View Post
Hi pisho...i asked the same question which you have posted her to Dr.steven daugherty(I am friends with him on FB)...This is what he replied...

The key is representing the patient's wishes, not what the family wants. Familys request is meaningless. Second, the dr lays out options and the patient choose. Inthe kaplan case, the family, prenenting the pts wishes want the treatment to continue.

hope this helps
hope thanks a lot, i see the thing now, the key is that YOU lay out the options, and the family chooses, so we decide when further treatments are futile or not, and thats about it.

cool that he replied , i like Dr.Daugherty!!
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Old 06-14-2014
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ya Dr.Daugherty is so cool..I love his lectures
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