End-of-life decisions relating to adults lacking capacity now fall under the Mental Capacity Act 2005 which came into force in 2007. The Act sets down principles by which the social and medical care of persons lacking the mental capacity to make their own decisions should be conducted. A Code of Practice provides guidance on the interpretation of the Act. We examined the wider effects of the Act in Chapter 6 . In this chapter, we will consider the implications of the Act for adults, like Tony Bland, lacking capacity.
But what of patients who retain capacity
noted the importance, reflected in numerous policy documents and research reports, of joined-up care for patients throughout the course of life, particularly as services are provided by so many different health and care organisations, and with varying funding arrangements. At no stage is coordinated care more vital than in older age and at the endoflife. This is not only because of the complexity of health and care arrangements, but also because many of the carers are also older and may be vulnerable themselves.
Older people are particularly
Improving end-of-life care in intensive
First I will define what I conceive medicine to be. In general terms, it is to do away
with the sufferings of the sick, to lessen the violence of their diseases, and to refuse
to treat those who are overmastered by their disease, realising that in such cases
medicine is powerless. (Hippocrates, c.400 BCE)
Politicians must address tough questions about limited resources. How many
teachers are you willing to fire in order to have 78-year olds have a procedure
which will be invented 5 years from
This book provides an ambitious overview of how topics related to death and dying are explored in modern Western theatre, covering a time-span of over a hundred years and engaging multiple cultural contexts. In a series of micronarratives beginning in the late nineteenth century, this book considers how and why death and dying are represented at certain historical moments using dramaturgy and aesthetics that challenge audiences’ conceptions, sensibilities and sense-making faculties. Chapters focus on the ambiguous evocation of death in symbolist theatre; fantastical representations of death in plays about the First World War; satires of death denial in absurdist drama; ‘theatres of catastrophe’ after Auschwitz and Hiroshima; and drama about dying in the early twenty-first century. The book includes a mix of well-known and lesser-known plays and performance pieces from an international range of dramatists and theatre-makers. It offers original interpretations through close reading and performance analysis, informed by scholarship from diverse fields, including history, sociology and philosophy.It investigates the opportunities theatre affords to reflect on the end of life in a compelling and socially meaningful fashion. Written in a lively, accessible style, this book will be of interest to scholars of modern Western theatre and those interested in death studies.
The Irish health system is confronted by a range of challenges, both emerging and recurring. In order to address these, it is essential that spaces are created for conversations around complex ethical and legal issues. This collection aims to provide a basis for ongoing engagement with selected issues in contemporary Irish health contexts. It includes contributions from scholars and practitioners across a range of disciplines, most particularly, ethics, law and medicine. The focus of the collection is interdisciplinary and the essays are situated at the intersection between ethics, law and medicine. Important issues addressed include admission to care homes; assisted suicide; adolescent decision-making; allocation of finite resources; conscientious objection; data protection; decision-making at the end of life; mental health; the rights of older people; patient responsibilities; stem cell research; the role of carers; and reproductive rights. From these discussion, the collection draws out the following interlinking themes, addressing difference; context and care; oversight and decision-making; and, regulating research. The essays are theoretically informed and are grounded in the realities of the Irish health system, by drawing on contributors’ contextual knowledge. This book makes an informed and balanced contribution to academic and broader public discourse.
Lessons Learned from an Intervention by Médecins Sans
Maria Ximena Di Lollo, Elena Estrada Cocina, Francisco De Bartolome Gisbert, Raquel González Juarez, and Ana Garcia Mingo
reduce transmission (e.g.
isolation) versus the mental health consequences of living or dying in solitude.
MSF aimed to ensure dignified treatment and care while reinforcing individual
autonomy. Support was given to care home staff to help residents with their
mobility, as well as facilitating calls or face-to-face visits with their
families. MSF also provided some assistance in the end-of-life process for the
last farewell. This was all done without
all the places where MSF was already working. Without any treatments, caring for
those patients was impossible and end-of-life support very difficult. Patients were
highly stigmatised, even by some in the medical profession. There was an internal
debate at the organisation about whether it was pertinent for MSF to do prevention
projects; because there was no vaccine, prevention was based solely on behavioural
changes like condom use and abstinence.
Patient-centred dying: the role of law
Death is not the opposite of life, but a part of it.
Haruki Murakami, Blind Willow, Sleeping Woman: 24 Stories
The way we die is a fundamental part of our life story. Yet, most of us dedicate
little time to thinking about how we want to die (McCarthy et al., 2010). It
seems inevitable in contemporary Ireland that the law will play an increased
role in decisions about the endoflife. There are several reasons for this.
Ongoing technological development and increased medical knowledge
that was not its primary purpose.
At the other endoflife, the Church, while condemning euthanasia, does not demand that extraordinary means be taken to prolong life. Where is the line drawn? Should a severely disabled baby be subjected to painful surgery with a low success rate? Must antibiotics be administered to the terminal cancer patient stricken with pneumonia? The doctrine of double effect, and the application of a distinction between ordinary and extraordinary means to preserve life have generated substantial literature and debate. 52 Nonetheless
on it, has
not gone away.
This is understandable. Death and dying invariably involve a plethora of thorny issues. With increased secularisation in many industrialised Western societies, religious assurances about the existence of
an afterlife have faded, lending credence to the rationalist credo that
one’s earthly existence is total. And yet, belief in posthumous spiritual
existence persists. Most pressing are concerns about end-of-life: specifically, the form it will take, its duration, and the degree of agency
one will have. It is common for dying people – as