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Terminal care in old age psychiatry: a survey of professionals' attitudes and approaches

Published online by Cambridge University Press:  02 January 2018

Josephine Anne Richards  and
James Lindesay
Josephine Anne Richards
Affiliation:
Towers Hospital, Leicester LE5 OTD
James Lindesay
Affiliation:
University of Leicester, Leicester General Hospital, Leicester LE5 4PW
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Few clinical decisions are more difficult than whether or not to withhold treatment from patients who are unable to make this choice for themselves. This is because they bring into conflict a number of principles central to clinical practice, such as the duty to save life, the duty to relieve suffering, and the duty to heed patients' wishes. In North America, advance directives (‘living wills’) from patients, made when they are fully competent, have achieved considerable popularity in recent years as a possible way out of these dilemmas (La Puma et al, 1991; Molloy et al, 1991); unfortunately, it is by no means clear whether these can in fact provide a workable solution to the problem of treating incompetent patients (Hope, 1992). For the time being, decisions about withholding treatment will continue to be made by the health professionals immediately involved at the time, often junior staff with little experience or training, and there is a need for a professional consensus as to the factors that should be properly taken into consideration. This study investigates the current attitudes and approaches of psychiatrists and psychiatric nurses in one health district to this problem. It examines the criteria used, and the conditions under which decisions about administering or withholding treatments are being made.

Type
Original articles
Information
Psychiatric Bulletin , Volume 17 , Issue 4 , April 1993 , pp. 207 - 209
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists 1993

References

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