About this episode
These challenging scenarios represent opportunities to provide truly patient-centered care at life's most vulnerable moments. By combining your medical expertise with thoughtful communication, you can help ensure patients' wishes are honored while supporting families through difficult transitions. In this episode we dive into the complex ethical and legal dilemmas faced by EMS providers when arriving on scenes involving Do Not Resuscitate (DNR) and goals of care forms. With special guest Dr. Daniel Markwalter, an emergency physician and hospice/palliative care expert, the discussion touches on understanding the importance of these forms, the challenges of making decisions without clear directives, and strategies for effective communication with family members when they suddenly disagree with the form. This episode provides valuable insights and practical advice for EMS professionals who can be faced with these sometimes challenging scenarios.
00:00 Introduction: The Ethical Dilemma in EMS
00:49 Sponsor Message: The Recess Tailor
01:53 Case Study: Evening Shift Dilemma
03:33 Expert Insights: Dr. Daniel Mark Walter
04:40 Understanding Hospice and DNR
09:48 Advanced Directives and Code Status
19:20 Challenges with Comfort Care and Advanced Directives
26:19 Aligning Medical Knowledge with Patient Goals
28:34 Understanding Goals of Care
29:03 Respecting Autonomy in Medical Decisions
30:02 Effective Communication with Families
31:45 Navigating Family Overrides in Critical Moments
32:36 Legal Aspects of Surrogate Decision Making
36:00 Exploring Illness Understanding and Prognosis
45:46 Symptom Management in Palliative Care
49:43 Final Thoughts and Summary
Resources
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The Resus Tailor
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