Some doctors choose to ask other members of the health care team to help them plan ahead (such as a nurse, physician assistant or social worker). Once the patient`s ideas have been gathered, the physician can focus on the basic conversations in direct conversations with the patient, the representative, and the family. The preparatory work will enable these discussions to get straight to the point and be effective. Once the basic conversation has taken place, invite the patient to think about things, and then return for an exam with decisions at a later visit. «Bioethics» refers to this restrictive treatment or the rejection of futile treatment options such as «rationing of care» in cases where the unanimous decision to refuse prior treatment is not made jointly by patients and their health care providers. There are no strict criteria for distinguishing senseless treatment; Therefore, reliance must be placed on expert judgement and case forecasting. Given the aspect of access to quality care for those who need it most, rationing of care may be justified in a futile situation. Rationing of care is present in the current health care system and can be justified as just justice if done ethically and justly [9]. The allocation of medical resources is often limited and must therefore be distributed equitably. It is necessary to evaluate and evaluate medically advanced treatments to avoid overuse of already limited resources.
This can be achieved through good education, knowledge of the implications of advanced treatments, and better healthcare decision-making for patients, their families, and physicians [7]. You can think of advance care planning as one of many health promotion activities. These discussions aim to prevent harm (overtreatment and undertreatment) and promote benefits (treatments tailored to the patient`s goals). You need to reassure the patient that addressing this issue does not mean there is anything unspoken to worry about. You can also tell the patient that this topic is difficult for many patients and that you will understand if she does not want to draw conclusions during this conversation. You may want to refer the patient to one of the many reputable advance care planning sites on the Internet to encourage further examination and preparatory steps to advance care planning (see Further Reading). It is difficult for the general population seeking medical care to understand the concept of limited treatment in case of failure. The responsibility to limit medical care is surrounded by ethical questions, as patients and their families do not understand the need to limit treatment in some cases where it is unnecessary. Health care providers and physicians are working on this difficult task of getting patients to understand the need to refuse treatment, as it may not benefit them and, in some cases, cause harm. You should inform the patient that the best thing to do in these circumstances is to write down her wishes and give a copy to her health care providers. She should fill out a legal form, such as a living will, with as much detail as possible, and then provide more detailed values and preferences to better understand her wishes.
Copies of completed documents must be provided to any clinic or health facility where the patient is being treated. Living wills should only be issued if a person cannot make their own decisions. Autonomy is a person`s right to make decisions for themselves and express their values. Advance planning promotes autonomy and the right of the individual to control medical decision-making. A living will extends autonomy at a time when the person becomes incapable. End-of-life treatment decisions involving multiple stakeholders are very likely to raise several ethical and moral concerns. Healthcare professionals can play an important role in providing detailed information about advanced medical treatments that can be applied during end-of-life care. Doctors can legally fulfill their duties by providing patients with detailed information about the advantages and disadvantages of this treatment. Physicians can work according to «ethical theory» and perform their duties in order to achieve the greatest good for the patient and to act for the benefit of the patients [4]. Although the patient has the autonomy to choose a treatment, the doctor can explain its effects and try to highlight the consequences. Here, the patient must fulfill a duty of self-kindness in order to make an autonomous decision as a competent individual to undergo treatment and prolong life or forego senseless treatment for the greater good of society, saving costs and emotional stress.
If the patient insists on prolonging his or her life with medically advanced treatment interventions, which, according to the medical assessment, may be unnecessary, the physician has the utmost responsibility to explain the informative facts about withholding or withdrawing medical treatment and to ensure that there is no unnecessary use of resources for futile treatment without causing harm to the patient.