Difficult decisions and ethical dilemmas that I mostly encounter:
1. FEEDING AT THE END OF LIFE OF A PALLIATIVE PATIENT
* FEEDING is always a sensitive topic to discuss with the parents of a terminally ill patient/child
* Some mothers find it very difficult, that if feeding is continued, it can be futile to the child
*Important to explain to the mother the benefits and burdens of continued feeding
*Explain to the mother, that feeds may cause unnecessary discomfort to the child eg aspiration
* Despite all, mothers still believe that the child will die of hunger and must be fed till the very end
2. USE OF SEDATION AT THE END OF LIFE
*Since we all have Google access, some mothers/ family members will search for the effects and side effects of a particular drug eg morphine, then refuse the administration of it
*Although explained: that it is a myth, it will not hasten death
* purpose of treatment ( morphine) to alleviate suffering, not hasten death
* to achieve symptom control
*reassure parents that treatment aligns with the patient’s prognosis
THUS IMPORTANT BY ENSURING CLEAR AND EMPHATIC COMMUNICATION AMONGST ALL PARTIES INVOLVED.
