Listen to this amazing podcast, recommended for residents, families and healthcare professionals:
The issues that are raised by these situations are really hard, as they involve complex and sometimes competing ethical values, including:
• The duty to rescue, to save life, to be a “lifeguard”
• Judgements about quality of life, made on the part of patients about their future selves, and by clinicians (and surrogate decision makers) about patients
• Age realism vs agism
• The ethics of rationale suicide, subject of a prior GeriPal episode
• Changes in medical practice and training, a disconnect between longitudinal care and acute care, and frequent handoffs
• The limitations of advance directives, POLST, and code status orders in the electronic health record
• The complexities of patient preferences, which extend far beyond code status
• The tension between list vs goals based approaches to documentation in the EHR
Kentish GP Service 