Domain 8 : End of life care
Death is inevitably a managed, not a 'natural' process in intensive care. The manner in which it is conducted may affect the survivors - family and staff - for the rest of their lives. Treatment limitation or withdrawal does not mean denial of care; patients should not suffer, and, where possible, their wishes should be determined and respected.
By the end of specialist training, the trainee...
| 8.1 Manages the process of witholding or withdrawing treatment with the multidisciplinary team |
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| 8.2 Discusses end of life care with patients and their families / surrogates |
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| 8.3 Manages palliative care of the critically ill patient |
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| 8.4 Performs brain-stem death testing |
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| 8.5 Manages the physiological support of the organ donor |
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Features of competent performance
- Assessment of severity of illness and prognosis
- Awareness of relevant ethical / legal / religious / cultural issues
- Effective communication and interpersonal skills - patient / family / staff
- Effective team-working: promote collaboration, communication & continuity
- Attempt to minimise distress - patient / family / staff
- Clear decision making and plan of management
- Appropriate referral / consultation
- Recognition of limitations (self and others)
- Attention to patient safety
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