Preconditions | |
1 | The patient is confirmed as being in a permanent vegetative state from which recovery of awareness is highly improbable |
2 | There is no dispute that withdrawal of CANH is in the patient's best interests, taking into account their likely wishes, values and beliefs, so far as these are known |
3 | Appropriate plans are in place for management of end-of-life care according to best practice, including backup plans for specialist support |
Diagnosis | |
4 | There has been an adequate time frame for improvement—at least 6 months post-non-traumatic brain injury, or 12 months post-traumatic brain injury |
5 | The patient has undergone an adequate period of assessment by appropriately trained and experienced PDOC assessors in a designated specialised PDOC unit (or by a specialist PDOC outreach service) |
6 | Assessment has been conducted according to the RCP guidelines using two or more of the approved structured assessment tools:
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Confirmation | |
7 | The above must be confirmed by two independent physicians who meet the requirements for experience and training in PDOC, as set out in the RCP PDOC guidelines |
8 | Their assessment confirms that the conditions above have met the standards of best practice as laid out in RCP PDOC guidelines including:
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CANH, clinically assisted nutrition and hydration; PDOC, prolonged disorders of consciousness; RCP, Royal College of Physicians.