Abstract
In caring for dying patients, family medicine practitioners intentionally adopt care plans that affect the manner and timing of death. These decisions are morally weighty. This article provides guidance regarding the ethical and legal appropriateness of practitioner decisions near the end of life. Topics include surrogate decision making, advance care planning, medical nutrition and hydration, double effect, futile care, physician-assisted death, voluntarily stopping eating and drinking, palliative sedation to unconsciousness, and cultural humility.
Keywords:
Advance care planning; End of life; Ethics; Futility; Palliative care; Palliative sedation; Physician-assisted suicide; Surrogate.
Copyright © 2019 Elsevier Inc. All rights reserved.
MeSH terms
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Advance Care Planning / ethics
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Advance Care Planning / legislation & jurisprudence
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Analgesics, Opioid / administration & dosage
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Decision Making*
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Humans
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Hypnotics and Sedatives / administration & dosage
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Nutrition Therapy / ethics
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Palliative Care / ethics
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Palliative Care / legislation & jurisprudence
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Patient Care Planning / ethics
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Patient Care Planning / legislation & jurisprudence
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Patient Preference
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Primary Health Care / ethics
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Primary Health Care / legislation & jurisprudence
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Prognosis
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Suicide, Assisted / ethics
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Suicide, Assisted / legislation & jurisprudence
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Terminal Care / ethics*
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Terminal Care / legislation & jurisprudence*
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Withholding Treatment / ethics
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Withholding Treatment / legislation & jurisprudence
Substances
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Analgesics, Opioid
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Hypnotics and Sedatives