Hospitals - an antonym for End
of Life Choices?
Moderator
Mark Yates - Director of Clinical Studies Deakin
University
Panel Members
• Julian Savulescu - Thinker in Residence, Deakin University, Uehiro
Chair in Practical Ethics, Oxford University, Editor in Chief, Journal of
Medical Ethics
• David Mitchell – Orthopaedic Surgeon, Chair of BHS Medical Staff
Group
• Bev Adams – Nurse with extensive experience in Dementia Care
• Bill Silvester – ICU Physician, Respecting Patient Choices National
Lead
• Penny Cotton – Palliative Care Physician
• Alfie Obieta – Geriatrician
• Teresa Grove – Deakin University Ballarat Clinical School
Community Advisory Board, Lawyer
The Canter Poll
• Editor of Nugget News.com Ms Nikki Velasco
How to use the Keypads
1.
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(The system will only count the last vote)
Are you
1.A nurse
2.A medical student
3.A member of allied
health
4.A doctor
5.Non –clinical staff
41%
38%
16%
3%
1
2
3%
3
4
5
Mary
What is your understanding about
Advanced Care Planning laws in
Victoria?
44%
1.
2.
3.
4.
Extensive
Moderate
Basic
Poor
28%
14%
1
14%
2
3
4
All Australian states and territories have specific
legislation regarding the documentation of
advance directives ?
1. True
62%
2. False
38%
1
2
Which of the following do you think is
the most appropriate course of action?
1) Ignore the son and treat
2) Contact her daughter
(her usual carer and
EPOA) who is overseas
3) Contact the GP
4) Do not treat – due to her
pre-existing ACD
outlining her wishes not
to have any medical
intervention
73%
14%
11%
3%
1)
2)
3)
4)
Hip Fracture
What do you think is the best course
of action?
1. Perform an urgent DHS
2. Seek urgent VCAT approval
for the DHS
3. Call Angela in Bali for
advice
4. Call a team meeting with
Paul and Angela which will
take 3 days (Paul is busy)
5. Give pain relief and return
to NH
29%
18%
18%
18%
16%
1
2
3
4
5
Who amongst the following do you think should
make the final decision on whether or not she
should get a DHS?
1) Her daughter, as the
EPOA
2) Her son, as the person
who is present
3) The Ortho registrar
4) The Ortho consultant
5) An emergency guardian
appointed by VCAT
6) All the above
56%
19%
11%
7%
7%
0%
1)
2)
3)
4)
5)
6)
What do you think is the best course
of action?
1. Urgent cardiac
catheterisation and
stent
2. Take the advice from
the daughter in Bali
3. Seek VCAT approval for
the catheterisation
4. Call a family meeting
5. Give pain relief and
return to NH
64%
19%
6%
1
8%
3%
2
3
4
5
If Advanced Care Plans were to become a legally
enforceable document the law should require
that hospital staff be made to follow them…
1.
2.
3.
4.
In all cases
Only when they are supported
by an Enduring Power of
Attorney
Only when they are supported
by an EPOA and are consistent
with “good medical practice”
Staff should not have to follow
ACPs but document they have
been consulted and the reason
for alternative action be
documented
37%
34%
29%
0%
good medical practice –means good medical practice for
the medical profession in Australia having regard to—
(a) the recognised medical standards, practices and procedures of
the medical profession in Australia; and
(b) the recognised ethical standards of the medical profession in
Australia. (s282A, in its Criminal Code 1899 (Qld)
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