Journal of palliative medicine
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Case Reports
Easing the burden of surrogate decision making: the role of a do-not-escalate-treatment order.
We present a case illustrating the common problem of a surrogate decision maker who is psychologically distressed over the medical team's recommendation to withdraw life-sustaining treatment. We suggest how a do-not-escalate-treatment (DNET) order can be helpful in such situations when the usual approaches to withholding or withdrawing care are not acceptable to the surrogate. We define a DNET order, explain when it might be useful, and discuss how it can facilitate a humane, negotiated resolution of differences.
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Physician-assisted dying (PAD) is legal in several countries in Europe and some states of the United States. Despite regular societal debate in New Zealand about assisted dying, little is known about what the New Zealand public think about this issue. The present study was the first to examine New Zealanders' attitudes toward assisted dying in the context of various parameters of patient suffering, and as a public policy issue. ⋯ The results have highlighted the high value respondents place on patient autonomy with regards to end-of-life choices; however the choice to hasten death is not a 'right' that should be available to all. RESULTS have clearly shown that New Zealanders believe regulation will play a key role in maintaining compliance with any assisted dying legislation, and in restricting access, so that only patients who are suffering intolerably and hopelessly are able to legally gain medical assistance to end their life.