Working within the legal framework for end-of-life decision-making in Queensland: The experience of Emergency Department and Intensive Care Unit healthcare professionals.
Jayne Hewitt1, Griffith University Southport 1Griffith University, Southport, Queensland, Australia
Abstract
Purpose
To describe how ED and ICU healthcare professionals’ experience end-of-life decision-making and identify the factors that affect the application of Queensland’s legal framework in this process.
Nature and scope of the topic
EDs and ICUs employ healthcare professionals that are trained to improve, support, and sustain life. For some patients, decisions about limiting treatment and offering supportive care must be made. In Queensland, legal frameworks set out who is authorised to make health-related decisions for adults who lack decision-making capacity, including decisions about limits to active treatment. Many factors make end-of-life decision-making in ED and ICU challenging and may affect the extent to which healthcare professionals can consistently and confidently work within the legal framework.
Issue under consideration
We undertook a descriptive qualitative study to identify the factors that affect end-of-life decision-making in ED and ICU and how the law is applied in these settings. Semi-structured interviews were conducted with medical practitioners, nurses, and social workers who had experience with providing end-of-life care to patients in ED or ICU.
Conclusions
Preliminary data analysis reveals that health professionals’ knowledge of the legal framework that supports end-of-life decision-making is variable. Decisions to limit treatment are primarily informed by medical practitioners’ assessment of the patient’s clinical condition and understanding of their treatment preferences. Decision-making is collaborative and does not necessarily rest on a sole authorised decision-maker. Advance Health Directives are most often used as a guide to a person’s preferences for treatment but are frequently perceived as uncertain and not relied upon.
Biography
Dr Jayne Hewitt is a registered nurse and legal academic. She is currently a Senior Lecturer in the School of Nursing and Midwifery at Griffith University, a Senior Research Fellow at QEII Hospital, and a Senior Research Fellow with the Law Futures Centre. Combining her clinical experience and interest in law Jayne’s research focuses on translating law into practice and issues in end-of-life care.