Legal and Ethical Symposium

Legal and ethical issues - DNACPR and treatment escalation planning in ICU

Learning outcomes

By the end of the Symposium, the participants will to be able to:

  • recognise the challenges around DNACPR and treatment escalation planning in a real-world situation or practice
  • identify situations which may lead to disagreements with colleagues and/or families
  • demonstrate knowledge on how to approach differing opinions
  • identify the multiple ethical interests at stake when making treatment-limiting decisions

Programme Programme

  • 10:15am - Registration and coffee
  • 10:30am - Introduction
  • 10:40am - Start-of-the-day quiz
  • 11:00am - The ethics behind DNACPR (Victoria Metaxa) - How easy is for patients to predict if they would want to be resuscitated? How can a patient decide without all relevant information? Autonomy vs best interests
  • 11:20am - Post Tracey – the law around DNACPR (Rob Tobin) - Do clinicians need to obtain consent for resuscitation decisions? What is the relevant UK legal framework?
  • 12:10pm - Panel discussion (answering your questions)
  • 12:45pm - Lunch
  • 1:45pm - Advance care planning – joining up with the community (Zoe Fritz) - is critical care the best place to discuss treatment-limitation decisions? Is anyone discussing resuscitation outside critical care? Can advance care planning be of use in ICU?
  • 2:15pm - How to make treatment-limiting decisions/a framework (Dan Harvey) – are decisions around end of life a form of art?  Are they only based on clinicians’ personal beliefs? Can they be made in a structured way?
  • 2:45pm - Coffee
  • 3:00pm - Application of advance decisions in ICU – fit for purpose? (Thea de Beer) – should all ICU patients have DNACPR decisions? Do advance decisions change ICU treatment? Would an à la carte menu of treatment choices be appropriate when treatment limitation is considered?
  • 3:30pm - Managing disagreements and lack of consensus (Anna Conway-Morris) - why is conflict so frequent in ICU? Can it be averted? How can disagreements be resolved?
  • 4:00pm - End-of-the-day quiz
  • 4:15pm - Panel discussion (answering your questions)
  • 4:30pm - Close