Good end of life care helps patients with life-limiting conditions to live as well as possible until they die, and to die with dignity. This essay is intended to support individuals in decision-making and help them to provide patients with high quality end of life care, including involvement of and support for those close to the patient (family members, carers and others who have an interest in their welfare). Providing this care means facing decisions which may be clinically complex and emotionally distressing and the guidance explores how doctors can address these issues. Long-established ethical principles, which include doctors’ obligations to show respect for human life; protect the health of their patients; and to make the care of their patients their first concern. This guidance also takes account of, and is consistent with, current law across the UK, in particular the law prohibiting killing (including euthanasia) and assisted suicide and the requirements of the Human Rights Act 1998. Annex A contains references to relevant case law and legislation. However it is not intended as a substitute for up to date legal advice in individual cases. Good end of life care helps patients with life-limiting conditions to live as well as possible until they die, and to die with dignity. Life-limiting conditions’ includes Organ or systems failure, where patients are likely to die suddenly as a result of an acute crisis, life threatening acute conditions caused by sudden catastrophic events and progressive conditions such as cancer and dementia.
The framework for decision-making in end of life care is essentially the same as for any other phase of clinical care. The principles of good decision-making are set out in Consent: patients and doctors making decisions together , which also provides advice about how to communicate effectively, and work towards achieving a consensus, with patients and those close to them and within the...