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NHPCO March ECHO Session - Shared screen with speaker view
Judith Adams
47:43
Would you put the case back up on screen?
Thaddeus Pope
47:58
The report to APS. Was that made by TL staff? Was that because there were concerns about whether the patient voluntarily chose VSED?
Dana Tarcatu
51:01
What were the efforts to identify the reason he was expressing a desire to die? And what is the connection between hastening death and not taking his usual medications (which in some situations could actually have a positive outcome)?
Syl Zucker
55:22
What about asking any pt who is demonstrating tiredness continuing living the general question if they are interested in knowing ones end of life options
Thaddeus Pope
58:25
Generally accepted (legal and professional) rules of informed consent require disclosing ALL options that a reasonable patient might find significant or important. Therefore, omitting some options should require special and overwhelming justification.
Judith Adams
01:03:27
Sorry. I need to leave early. Great conversation
Thaddeus Pope
01:03:48
Leslie Sutton - If the patient still had capacity when she asked for water, then EVEN a clear advance directive with Ulysses Clause may not have been sufficient. As you describe it, this was a revocation of the VSED plan. So, the DPOAHC no longer had authority to enforce the VSED plan since the patient herself no longer wanted that. Thank you.
Dana Tarcatu
01:08:53
Did the team take into consideration that this was a situation happening during the COVID -19 pandemic, when most people in ALFs and NH/SNFs were experiencing social isolation, which has a great impact on their outlook on life? And I agree VSED would have not been an appropriate recommendation to make.
Halley Harris, MSW
01:10:08
I would encourage education across the board both with clinicians and families. Some we use in WA State are www.endoflifewa.org or www.vsedresources.com
Thaddeus Pope
01:11:30
Halley is right and Washington State has some of the best resources anywhere. We (a physician, nurse, ethicist, and lawyer) just published a book length treatment of clinical, ethical, legal, and institutional issues re VSED https://global.oup.com/academic/product/voluntarily-stopping-eating-and-drinking-9780190080730?cc=ch&lang=en&
Syl Zucker
01:11:54
Often pts exercising VSED do not stop eating and drinking "cold turkey" but ease into it. We discuss with pts and families what a hard line VSED choice vs an easing into VSED might look like
Karuna Tamrakar
01:12:34
From Debra- Thank you Halley. Another resource compassionandchoices.org has a good discussion regarding VSED
Sean Murphy
01:12:41
In jurisdictions where assisted death is not yet legal, are there any resources for supporting staff who are facilitating VSED potentially for the first time?
Katie Adkison
01:15:23
Support the individual in their decision and respect explaining what the impact may be...
Heather Thornburg
01:17:23
We had a patient do this a few years ago & at that time, we didn't even know there was a name for it. It was just the patient choice and we supported him as he needed.
Sean Murphy
01:17:34
Thank you for the clarification, didn't mean to imply that VSED was aided death.
Katie Adkison
01:18:06
Thank you for this ECHO presentation and thoughtful discussion.
Heidi Seaberg, NP
01:18:21
Excellent case! Thank you all.
Tracy Larson-Benvenuti
01:18:29
Wonderful presentation thank you!
Bonita Westover
01:19:20
Thank you all very much! I thoroughly enjoy & learn so much from Project ECHO sessions.
Darci Reed
01:19:25
Thank You
Shannon Winters
01:19:40
Thank you
Tamilyn Little
01:19:45
thank you!
Tuesday Riegen
01:19:48
Thank you for a great session!
Ruth Blackman
01:19:56
A suggests for the future: if here are multiple excellent cases like these, could they be labeled 1,2,3 or A, B C for ease of reference during discussion?
Theresa Lynn
01:19:58
Thank you - very helpful!
Ashley Evans
01:20:13
Thank you
Becky
01:20:14
Thank you. This was a great topic!
Karuna Tamrakar
01:20:29
Thank you for participating in ECHO session! we value your feedbacks and sharing your knowledge and expertise.