End-of-life care

In giving culturally safe end-of-life care the practitioner: (a) understands how far healthcare can go in extending life and recognises when efforts to prolong it may not serve the patient; (b) accepts the patient's right to refuse treatment or ask for it to be withdrawn, while making sure they receive relief from distress; (c) respects diverse cultural practices and beliefs about death and dying; (d) facilitates advance care planning and provides end-of-life care where relevant, consistent with any valid advance care directive, local policy and the law; and (e) takes reasonable steps to support patients and families even where their expectations or wishes cannot be met, especially where views differ.

• Advance care directives or plans filed in the record and checked before treatment decisions
• Notes of end-of-life discussions with patient and family, including cultural or religious preferences
• Records of palliative symptom management and referral to palliative services

• Advance care directive held elsewhere and not consulted
• Refusal of treatment recorded without a plan for comfort care
• Family disagreement handled without documented support or escalation