Physician-facilitated designation of proxy decision maker.

Amit Arora,Peter Crome,Laura Cummings

doi:10.1186/s13584-016-0084-5

Abstract

With vast improvements in healthcare in recent decades, people are living longer but often with higher rates of morbidity and chronic illnesses. This has resulted in a higher proportion of the population who may benefit from early end-of-life ‘conversation and planning’, but also gives healthcare professionals more time during which these discussions are relevant, as people live longer with their chronic diseases. A survey conducted by Lifshitz et al (Isr J Health Policy Res 5:6, 2016) sought to assess physician awareness and willingness to discuss designating a proxy decision-maker with patients, in order to aid end-of-life care in the event that the patient is rendered unable to make or communicate these decisions later in life.Their article suggests that proxy decision-maker designation is only one aspect of end-of-life care; a challenging area littered with ethical and moral dilemmas. Without early, open and frank discussions with patients regarding their wishes at the end of life, proxy decision-makers may be in no better position than physicians or a court appointed proxy to make decisions in the patients’ best interests/benefits. This commentary also touches upon the use of health and care passports being developed or in early phases in the United Kingdom, and whether these may be utilised in the field of palliative care in Israel.

Highlights

Palliative care is a relatively new medical specialty, experiencing a period of rapid growth and development following the opening of St
The principles of palliative care centre on holistic care of the person who is usually in the final phase of life, including addressing psychological and spiritual needs, as well as enabling the patient to live as actively as they wish until death [1]
It is important to note that, where formal palliative care services exist it is not confined to patients who are deemed end-of-life, that is primary focus of this commentary

Summary

Introduction

Palliative care is a relatively new medical specialty, experiencing a period of rapid growth and development following the opening of St. It is important to note that, where formal palliative care services exist it is not confined to patients who are deemed end-of-life, that is primary focus of this commentary. * Correspondence: amit.arora@uhnm.nhs.uk 1University Hospital of North Midlands, Stoke on Trent, UK 2Keele University, Keele, Stoke on Trent, Staffordshire, UK Full list of author information is available at the end of the article intubation, preferred place of dying, and even cardiopulmonary resuscitation can be extremely sensitive issues.

Results

Conclusion