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Palliative Care Ethics$
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Fiona Randall and Robin Downie

Print publication date: 1999

Print ISBN-13: 9780192630681

Published to Oxford Scholarship Online: November 2011

DOI: 10.1093/acprof:oso/9780192630681.001.0001

Clinical treatment decisions

Chapter:
(p. 164 ) 8 Clinical treatment decisions
Source:
Palliative Care Ethics
Author(s):

Fiona Randall

R.S. Downie

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780192630681.003.0008

This chapter discusses distinctions between medical treatment and care, benefits to burdens/risks calculus, obligations and options in treatment decisions, life-prolonging treatments, treatments to alleviate suffering, the role of relatives, conflicts of interest between patients, reassessment of treatment decisions, autonomous to non-autonomous conditions, and advance statements and proxy decision makers. Treatment options are selected by carers on the basis of the benefits to burdens/risks calculus. They are then offered to autonomous patients, or considered by carers and relatives on behalf of non-autonomous patients. The tightness or wrongness of life-prolonging and life-sustaining treatments in palliative care depends on the particular clinical circumstances in which they are considered. Carers should not intend to cause overall harm to patients in the interests of relatives, but it is sometimes morally justifiable to compromise the good of one patient in the interests of others.

Keywords:   burdens/risks calculus, life-prolonging treatments, alleviating suffering, proxy decision makers, non-autonomous patients

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