I had to research the answer ...
So, assuming there is no written instructions from the Patient*, nor an enduring Power of Attorney**
Implementation Guideline
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Withholding and Withdrawing Life
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Sustaining Measures
Page 7 of 61 Part 2
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Ethical and Special Considerations
2.2
Patients without capacity
Where treatment is able to prolong the patient‘s life but there are doubts about whether it would provide overall benefit, the health care team and those close to or representing the patient should take account of the patient‘s wishes, values and preferences in order to assess whether treatment would be in the patient‘s best interests.
In assessing best interests in the case of an adult without the capacity to make decisions about health matters on their own behalf, account must be taken of the following:
- the patient‘s wishes and the views of those closest to them about what is in the patient‘s best interests (where the patient has agreed to their involvement)
- views of culturally appropriate people close to the patient
- beliefs and values that would be likely to influence the decision if the patient had capacity
- clinical judgements about the efficacy of the proposed medical treatment
- likelihood of the patient experiencing severe intractable pain or suffering
- level of awareness patients have of their existence and surroundings and their ability to interact with others, and demonstrate self-directed action in any capacity
- likelihood and extent of any degree of improvement in the patient‘s condition if treatment is provided whether the invasiveness of the treatment is justified in the circumstances
- likelihood of the patient experiencing increasing levels of disability and/or lack of function and dependence
- views of the patient‘s significant others (such as spouses, children and friends), as to what the patient would see as beneficial views of any duly appointed health care attorney or patient advocate
- that decisions must be made on an individual basis and that no unjustifiable discrimination occurs
- that all patients are entitled to the same quality of care, and that those who lack capacity should not be excluded from potentially beneficial treatment options solely by reason of their lack of capacity
- that decisions must not be based on whether the health care team, or the patient‘s relatives or carers, would wish to have the treatment themselves in that situation
- that decisions about best interests must not be motivated by a desire to bring about the patient‘s death.
* My Uncle, who I helped take care of passed when he was 91. He had a binding 'do not resuscitate' written instructions.
- This list is by no means exhaustive and can include written statements made by the patient before capacity was lost. In some cases the patient might like to have their families make statements on their behalf.
** My Sister has an enduring 'Power of Attorney' so, should I be incapacitated to make decisions, she had the legal authority to make decisions as if 'she was me'.Hope that answers the question



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