Manchester University Press
16 Improving end-of-life care in intensive care units
Abstract
This chapter provides an analysis of the state of critical care provision in Ireland and of how the withdrawal or withholding of therapies usually happens. It argues that the withdrawal of life-sustaining therapies is not simply a medical matter, but one with considerable social and political dimensions. It identifies the need for public discourse on the subject and for the development of a public policy on critical care. It argues that the answers to the dilemmas that critical care raise cannot most effectively be attained through the courts, but rather the solution is to be found in a social contract on the use of expensive and resource intensive medical technology.
Abstract
This chapter provides an analysis of the state of critical care provision in Ireland and of how the withdrawal or withholding of therapies usually happens. It argues that the withdrawal of life-sustaining therapies is not simply a medical matter, but one with considerable social and political dimensions. It identifies the need for public discourse on the subject and for the development of a public policy on critical care. It argues that the answers to the dilemmas that critical care raise cannot most effectively be attained through the courts, but rather the solution is to be found in a social contract on the use of expensive and resource intensive medical technology.
Chapters in this book
- Front matter i
- Contents v
- Contributors vii
- Series editor’s foreword x
- Introduction 1
-
Part I Context and care
- 1 Reproductive justice in Ireland 9
- 2 Conscientious objection, harm reduction and abortion care 24
- 3 Why care about carers? 41
-
Part II Rights and responsibilities
- 4 The limits of autonomy 55
- 5 If they can consent, why can’t they refuse? 71
- 6 Patient autonomy and responsibilities within the patient–doctor partnership 84
- 7 Older people, human rights, law and policy 101
- 8 Legal and ethical considerations in involuntary admissions to long-term care 117
-
Part III Regulating research
- 9 Retention and use of human biological samples 135
- 10 A moral gap? 150
- 11 Children in clinical trials in Ireland 163
-
Part IV Oversight of decision-making
- 12 Governance failures and organisational ethics 179
- 13 Psychiatric admission in Ireland 194
- 14 Protecting rights in mental health law 208
- 15 Patient-centred dying 222
- 16 Improving end-of-life care in intensive care units 236
- Index 251
Chapters in this book
- Front matter i
- Contents v
- Contributors vii
- Series editor’s foreword x
- Introduction 1
-
Part I Context and care
- 1 Reproductive justice in Ireland 9
- 2 Conscientious objection, harm reduction and abortion care 24
- 3 Why care about carers? 41
-
Part II Rights and responsibilities
- 4 The limits of autonomy 55
- 5 If they can consent, why can’t they refuse? 71
- 6 Patient autonomy and responsibilities within the patient–doctor partnership 84
- 7 Older people, human rights, law and policy 101
- 8 Legal and ethical considerations in involuntary admissions to long-term care 117
-
Part III Regulating research
- 9 Retention and use of human biological samples 135
- 10 A moral gap? 150
- 11 Children in clinical trials in Ireland 163
-
Part IV Oversight of decision-making
- 12 Governance failures and organisational ethics 179
- 13 Psychiatric admission in Ireland 194
- 14 Protecting rights in mental health law 208
- 15 Patient-centred dying 222
- 16 Improving end-of-life care in intensive care units 236
- Index 251
