Presentation Information
[SY-88-02]Safeguarding Lives: Integrating Patient Safety and Clinical Ethics in Euthanasia
*Yumi Matsumura (Department of Patient Safety, Kyoto University Hospital(Japan))
Keywords:
Patient Safety Office,clinical ethics consultation,cancer,euthanasia
The Department of Patient Safety Office (PSO) at Kyoto University Hospital also serves as a Clinical Ethics Consultation Center. Here, we present our experience with an ethical consultation for a terminally ill cancer patient who requested to hasten death. The patient had completed treatment and was preparing for discharge when a CT scan, intended to confirm the effectiveness of the treatment, revealed that the cancer had spread. Devastated, he refused to eat or drink.Uncertain how to proceed, the attending physician consulted a psychiatrist, who, after evaluating the patient, confirmed his competence and determined that his refusal to eat was not due to delirium and that his decision-making capacity remained intact. Seeking further guidance, the physician turned to the PSO, which framed the situation as an ethical dilemma and recommended consulting an oncology psychiatrist.The oncology psychiatrist met with the patient, first confirming his wish to die, then gently encouraging him to reflect on his life journey. By the end of their conversation, the patient reconsidered his stance and expressed a willingness to accept food. Instead of choosing euthanasia, he opted to spend the remainder of his life in hospice care.This case highlighted the PSO's potential to take a more proactive role in addressing ethical issues within team-based medical care and supporting patient decision-making. Perhaps the patient did not genuinely wish to die. Through conversation, revisiting one's past provided a foundation for moving forward and embracing the time that remained. With deep knowledge of available resources within the hospital, the PSO goes beyond ethical reflection to actively promote concrete action. When combined with a clinical ethics consultation function, PSOs may effectively serve as advisory hubs for ethical concerns.