ALGORITHM 2: DECISION TO WITHDRAW ICD THERAPY IN AN ADULT PATIENT WHO LACKS CAPACITY TO MAKE DECISION Patient lacks capacity to make decision appointed under Lasting therapy, which is No advance Power of Attorney (LPA) valid and No advance decision, decision, no lasting to consent to withdrawal applicable to no Lasting Power of power of attorney of ICD therapy current Attorney, doctor in and no person charge consults those whom it is close to the patient re Patient has made an practicable or advance decision on appropriate to withdrawal of ICD consult Registered Attorney If failure to reach that in consensus on “best interests” to patient’s “best withdraw ICD interests” seek therapy second opinion. Attorney consents to wishes ICD withdrawal of PCT/Trust has a duty to provide therapy to ICD therapy the patient with access to an continue Independent Mental Capacity Advocate (IMCA) A
ALGORITHM 2: DECISION TO WITHDRAW ICD THERAPY IN AN ADULT PATIENT WHO LACKS CAPACITY TO MAKE DECISION Patient lacks capacity to make decision No advance decision, no lasting power of attorney and no person whom it is practicable or appropriate to consult No advance decision, no Lasting Power of Attorney, doctor in charge consults those close to the patient re Registered Attorney appointed under Lasting Power of Attorney (LPA) to consent to withdrawal of ICD therapy Patient has made an advance decision on withdrawal of ICD therapy, which is valid and applicable to current If failure to reach consensus on patient’s “best interests” seek second opinion. that in “best interests” to withdraw ICD therapy PCT/Trust has a duty to provide the patient with access to an Independent Mental Capacity Advocate (IMCA) Attorney wishes ICD therapy to continue consents to withdrawal of ICD therapy A