VP-NET Vulnerable Persons and End of Life New Emerging Team
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Ethical Frameworks and Decision-making

Research summary Ethics and End-Of-Life Care for Persons with Disabilities

In Canada there are a number of names for mechanisms that have been put in place to assist people who are thinking about end of life transitions, their families and caregivers anticipate the future, begin discussion and make decisions early on in their trajectory toward death. These are used to carry out specific requests regarding the provision or withdrawal of medical services as a person’s life draws to an end. 51

The preparation of an advance care directive can make discussions between people and their family easier, and provide guidance and support for substitute decision-makers who must make difficult decisions regarding life-sustaining treatment. If loved ones and medical professionals have engaged in a process of serious communication early on, the problems associated with the interpretation and application of advance directives are less likely to arise.52

  1. Do Not Resuscitate Orders (DNRs) instruct medical professionals not to revive a person in the instance of heart failure or if the person stops breathing. A person can request a DNR be placed on their medical charts or physicians can also place DNR’s on a patient’s chart, usually with their consent, although consent is not always required by law.
  2. Advanced directives are used to set out the healthcare decisions that are to be made and who should make them.
  3. Instructional directives tell the physician what types of treatment the patient does or does not want.
  4. Proxy directives designate a certain person to make the patient's medical decisions.53

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