Dr Jayne Hewitt1
1Griffith University
ABSTRACT
Purpose
To describe how Queensland’s legal framework for end-of-life decision-making is applied in Emergency Departments (ED) and Intensive Care Units (ICU).
Nature and scope of the topic
EDs and ICUs employ healthcare professionals that are trained to improve, support, and sustain life, but for some patients, life-sustaining treatment is not appropriate. In Queensland, legal frameworks set out who is authorised to make health-related decisions for adults who lack decision-making capacity, including decisions to withdraw or withhold life-sustaining treatment. Many factors make end-of-life decision-making in EDs and ICUs uniquely challenging, and they may make it difficult to apply the law consistently and confidently.
Issue under consideration
A retrospective chart audit of 85 adult patients who died in EDs or ICUs between May 2019 and September 2021 of one Queensland Health Service was undertaken, to examine how end-of-life decisions were documented, explore the extent to which decision-making processes aligned with the law, and identify the factors affecting how the law was applied.
Conclusions
Preliminary data analysis reveals that health professionals generally document decision-making processes that are consistent with Queensland’s legal framework. However, by the time such decisions are made it is common for the patient’s condition to have deteriorated to the point where death is inevitable, limiting the types of decisions that need to be made. Further research is being undertaken to better understand how end-of-life decision-making and the law intersect in ED and ICU.
Biography:
Dr Jayne Hewitt is a registered nurse and legal researcher. Jayne’s interdisciplinary research tackles the challenge of translating law into healthcare practice to achieve optimal patient outcomes. She is currently exploring the implementation of voluntary assisted dying, and how the law supports decision-making at the end of life.