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End-of-life care discussions encouraged

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Staff members should discuss the prospect of death with patients and what specific end-of-life care they would like, new guidelines have suggested.

The new guidance from the General Medical Council encourages end-of-life discussions with patients and their families in good time, particularly for people who are not expected to live beyond another year.

It is hoped this will give terminally ill patients more say on their treatment - especially when the risks and benefits are finely balanced.

The guidance says it is essential to pay attention to patients’ wishes. People who wish to die quickly can ask ahead of time for food and fluids to be withdrawn; however, the new rules stop short of discussing assisted suicide, which is illegal in the UK.

The guidance adds staff must start from a presumption that life should be prolonged and “must not be motivated by a desire to bring about the patient’s death”; however, they will not be expected to provide treatments that have no clinical benefit or that could do harm.

It says people who want to continue receiving food and fluids until the moment they die should normally be given them in cases where the benefits and harms carry a similar weight. A patient’s wishes around whether they are resuscitated should also be taken into account when doctors are deciding on treatment.

“When the benefits, burdens and risks are finely balanced, the patient’s request will usually be the deciding factor,” the guidance says.

However, doctors still have the final say and can withdraw treatments that are doing no good.

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