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  1. Brain stem signs
    pupils dilated + unreactive
  2. No corneal reflex
    V + VII
  3. No caloric response
  4. No gag reflex
    IX, X
  5. No cough reflex
  6. No breathing with high CO2
  7. The duty of care
    • the good of your pt is your primary conern- substantial benefit, an outcome which now or in the future the pt would regard as worthwhile
    • The pt has a life plan to be respected
    • the Dr has techniques falling within the bounds of reasonable medical practice
  8. Partnership
    means that pts and drs must change sharing responsibilities as well as info and decision making,2 to tange, both have responsibilities to help solve the problem.
  9. Ethical + legal duties
    • not wholly separable
    • law- interpretation
    • frameswork of interpretation is ethical
    • a reasonable position for a reasonable nz provider to take
  10. Death?
    • brain death?- GCS + brain stem
    • CVS death- the pittsburgh paradox
  11. PVS
    • Unconscious
    • severe diffuse neocortical damage-cardiac arrest or brain injury
    • diurnal EEG cycle
    • neuroimaging profile consistent w PVS
    • no responsiveness to events around
    • complete nursing care
    • artificial nutritin and hydration
    • no prospect of recovery
    • how does treatment benefit the pt?
  12. How do you know?
    tennis and spatial navigation imagery, less lit up
  13. RUB
    • risk of unacceptable badness
    • unacceptable
    • Cant be reconnected with the world
  14. Locked in syndrome
    • results from a lesion in the midbrain or Guillain Barre syndrome
    • Pt conscious but cant indicate it by any voluntary responses or other bodily actions
    • Can reconnect with the world
Card Set
The duty of care, dying, ethics, legal duties,
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