Standards › Standard 35 › Forms
Form · CRT-FRM-004 · Version 1.0 · Approved by the ASF Expert Committee
Supports: 35.6
Purpose
Records the decision to withdraw life-sustaining treatment, the clinicians and family involved, and the comfort plan.
How to complete
- Record the discussion and the people involved.
- Record the decision and the patient’s known wishes.
- Record the comfort plan agreed before withdrawal.
Checks
| Check | Entry |
|---|---|
| Clinicians and family involved | Yes |
| Decision and date | Yes |
| Patient’s known wishes | Yes |
| Comfort plan agreed | Yes |
Evidence
| Reference | Note |
|---|---|
| E-009 | Based on the Surviving Sepsis and critical care monitoring guidance, the NEWS2 early warning score (Royal College of Physicians, 2017), the Lancet Commission on Palliative Care (2018), and the WHO Global Patient Safety Action Plan 2021–2030. |
| E-006 | ASF Policy Framework v1.2. Adapted. |
| E-009 | ASF Expert Committee consensus. |
Change history
| Version | Date | What changed | Approval |
|---|---|---|---|
| 1.0 | the date of approval | First version | set Expert Committee approval |
E-learning for this document
References
- Accréditation Sans Frontières (2026). ASF Policy Framework v1.2. (E-006)
- Accréditation Sans Frontières (2026). ASF Expert Committee consensus on Standard 1. (E-009)