26 Questions
What is the main difference between quantitative futility and qualitative futility?
Quantitative futility involves interventions with very little chance of benefiting the patient, while qualitative futility involves interventions with a very insignificant benefit.
Who typically issues a medical certificate of death to the family?
The doctor
What is the role of a coroner?
Ordering and conducting inquests into the circumstances of death
In what situations might an investigation into the cause of death be carried out?
When the person died in suspicious circumstances or the cause of death is not apparent
What does a coroner have the authority to order as part of an inquest?
Post-mortem examination
What happens when a death is considered suspicious?
The coroner will order and conduct an inquest into the circumstances of death.
Who has the responsibility to register a death with the relevant authority?
The family member of the deceased
What is the purpose of a death certificate?
To record officially that somebody has died
What might be the reason for a post-mortem examination ordered by a coroner?
To establish the circumstances surrounding the cause of death
How does a coroner's decision regarding an inquest depend?
It depends on jurisdiction and surrounding circumstances.
When might a medical certificate of death be issued to the family by a doctor?
Only when there are no suspicious circumstances surrounding the death.
In what cases might a coroner's decision be made personally rather than by a jury?
If the cause of death is apparent and uncontested.
What is an advance directive?
A directive made in advance by a person with decision-making capacity outlining their will and preferences for any healthcare treatment decisions
When does an advance directive come into effect?
When the directive-maker lacks decision-making capacity to consent to or to refuse treatment
What can be set out in an advance directive?
Both a refusal and a request for treatment
What happens if a person has made a valid and applicable advance directive to refuse treatment?
It is legally binding and must be respected by the healthcare professionals
Under what conditions can healthcare professionals withhold life-saving or life-prolonging treatment based on an advance directive?
The treatment to be refused and the circumstances are clearly identified in the advance directive, and the directive-maker lacks decision-making capacity to overrule the advance directive
What are advance healthcare directives sometimes referred to as?
"Living wills"
What is the legal status of a DNAR form in England and Wales?
It is not a legally binding document.
What is the difference between an advance care plan and a Do Not Attempt Resuscitation (DNAR) form?
Advance care plans focus on future care while DNAR forms are only relevant to current care.
Under what circumstances should a health professional transfer care of a patient to another health professional?
If the patient's request is against the health professional's conscience.
What does 'medical futility' refer to?
Interventions that are not likely to produce any significant benefit for the patient.
In which situations can interventions such as mechanical ventilation or artificial hydration be withdrawn?
At any time, even without an advance care plan or directive
What is the main purpose of a Do Not Attempt Resuscitation (DNAR) form?
To instruct medical personnel not to attempt CPR for the patient
Who can develop an advance care plan if the person lacks capacity to express their own preferences?
Those closest to the person, with input from healthcare professionals
What is the difference between medical futility and withdrawal of treatment?
'Medical futility' refers to interventions unlikely to benefit the patient, while withdrawal of treatment refers to discontinuing interventions that are burdensome or ineffective.
Test your knowledge about advance directives, which are directives made in advance by a person with decision-making capacity outlining their will and preferences for any healthcare treatment decisions that may arise if he or she subsequently lacks decision-making capacity.
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