This course aims to improve medical decision-making for incapacitated patients without healthcare surrogates. The learning outcomes include understanding decision-making capacity, assessing capacity, and utilizing advance directives like POLST. The course teaches skills such as assessing capacity, navigating obstacles in decision-making, and involving an interdisciplinary team in the process. The teaching method involves lectures and case studies. The intended audience includes healthcare professionals, caregivers, and individuals interested in medical ethics and decision-making for vulnerable patients.
Better Medical Decision Making for Incapacitated Patients - UCLA Health Ethics Center
University of California, Los Angeles via YouTube
Overview
Syllabus
Unbefriended and Unrepresented: Better Medical Decision Making for Incapacitated Patients without Healthcare Surrogates
Biographical sketch 2. Experiences 1933 to 1939 3. Events during the war 4. Fate - how died or survived
Decision making capacity
What is "capacity"
significant benefits, risks and alternatives to proposed health care
Able to make a decision
That's the definition
When/How to Assess
Assess capacity carefully
Patients often lack capacity
Obstacle 2
Reasonable expectation of recovery
1 page form front & back
Recap
rd choice - After agent & surrogate
Ask court to appoint SDM
Last resort
Advance directive POLST
Increasingly common situation
Big problem
deaths
Growing problem
key factors
Nobody to authorize treatment
Treat aggressively
to appropriate setting
Need a consent mechanism
Who decides?
Interdisciplinary team
1. Physician 2. Registered professional nurse with responsibility for the resident 3. Other staff in disciplines as determined by resident's needs 4. Where practicable, a patient
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patterned on IDT
Variability
Solo physician
Most common approach
causes angst for the greater ethics community
Having a single health professional make unilateral decisions ...
Second physician consent
Attending physician Nurse familiar with patient Social worker familiar with patient Chair or vice-chair of HEC Non-medical (community) member of HEC
Expert Neutral
Quick Convenient
Taught by
UCLA Health
