GuidelinesOther guideline
Care of the Terminally Ill Patient
This booklet is intended as a practical guide to patient care for registrars, medical officers, interns and medical students attached to the gynaecology units at the University of the Witwatersrand Academic Hospitals. Anyone can use it.
Rights of the terminally ill patient
Patients may appear terminally ill when they are not. Extreme pain can subdue a patient & can make her appear very unwell. Severe dehydration & severe constipation, both correctable, may also give an impression of terminal illness.
Rights of the terminally ill patient
- The right to know the prognosis
- The opportunity for loved ones to know the prognosis (it is relatively obligatory to request patient permission)
- The right to decline treatment
- The right to discharge herself from hospital or to request discharge
- The right to receive adequate analgesia
Advice for clinicians
- Determine if the patient wishes to return to her original home to die
- Involve social workers / the Palliative Care Team / hospices where appropriate
- Ensure that the patient is adequately hydrated (this improves comfort)
- Give subcutaneous opiates by butterfly needle if oral medication cannot be taken
- Beware of what is said within earshot of apparently comatose patients
- Mark in the notes & tell on-call teams if a patient has a very poor prognosis