It seems to come with practice/ experience but I am much more used to using sedation at end of life and setting up a special care plan outlining DNAR. I still need to remember to rather note AND though.
So my ethical dilemmas are:
1) feeds at end of life; however learning that a small feed makes a person more hungry helps me make the decision to discontinue feeds easier. I agree as has been mentioned before to see a child not feeding is heart breaking and tough to witness.
2) withholding or withdrawing of life-sustaining treatments- I work in a public hospital so we need to use the ethical rule of distributive justice when deciding to start life-sustaining treatment. The most difficult decision thus for me, as was mentioned in the course is more the withdrawing of life-sustaining treatment – is the inotrope prolonging this child’s life unnecessarily? Is the high pressure on the vent really required if the sats are low anyways? have all the family had the opportunity to come to visit the child before we withdraw the treatment? It is agonizing and heart-breaking to speak to the family, to tell them such difficult to hear news that their child is brain dead and the life support machine is keeping the heart and lungs working.
