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To resuscitate or not to resuscitate; that was the
question!
The two background papers for the evening’s discussion
centred around CPR in continuing care setting and the efficacy of performing
CPR on these patients; as well as attempted suicide and the ethics of treating
or not treating a patient who is likely to die as a result of their attempt.
Interestingly, one paper was co-authored by Dr Don Chalfin
from the USA who is one of the keynote speakers at the national ACAP conference being held
in Adalaide from 2-4 November at the Adelaide Convention Centre
The audience consisted of a broad spectrum of ambulance
personnel from career and volunteer stations as well as palliative care
researchers and nurses from around the state.
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The Panel
The panel for the evening consisted of Dr Brian Stoffel, a
health ethicist and ethics committee member from Flinders University; Dr Laurie
Palmer, a one-time member of SAAS’ Medical Advisory Committee, ED doctor at QEH
and currently a palliative care specialist at Modbury hospital; Rob Elliott,
head of clinical and operational services for SAAS; and SAAS Medical Director,
Dr Hugh Grantham.
Here are some of the salient points that came up throughout
the evening.
1.Is it okay to practice
on people you believe are not going to survive?
The group was divided. It is not illegal. Ethics are
questionable.
2.Is CPR effective enough too always start?
Not really. Most times we are just going through the
process.
3.If you do start CPR there are two possible outcomes:
(a) live
(b) die
If you don’t try there is only one outcome.
4.The Queen
Elizabeth Hospital now places directives in the green book for patients.
This could create some legal questions, but gives a great
indication to patients’ wishes at the it was written.
5.Organ donation: is there a point in resuscitating for
this reason?
Sometimes they can harvest corneas, but not usually anything
else.
6.Time to get used to the idea of a patient dying.
Can be perceived as easier for family, but it is not
necessarily always the case.
By Tracy Callanan, Membership secretary, ACAP SA
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