Ethical Dilemmas Within Intensive Care
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Although there is no legal obligation to maintain life on either religious or secular grounds, preservation of life should be the default position unless there is strong evidence that life-sustaining medical treatment will be unsuccessful in the short term or in restoring an acceptable quality of life in the longer term.
Under the Mental Capacity Act 2005 (UK), there is an obligation to involve an independent mental capacity advocate (IMCA) when a patient lacks capacity and has no next of kin to provide representative opinion.
Although the next of kin of an incompetent patient have limited authority for decision making (unless a lasting power of attorney for welfare has been granted), they should always be involved to determine the patient’s values and beliefs upon which decisions about best interest can be made.
The early use of genuinely independent opinions can help to minimize or resolve conflict with the next of kin.
For the protection of all parties, the ultimate point of reference in all ethical dilemmas is the law.
The number and range of ethico–legal problems within critical care are likely to escalate in future years.
KeywordsOrgan Donation Mental Capacity General Medical Council Incompetent Patient Custodial Sentence
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