...Advance Directives are our wishes when we are at end of life stages of life that give specific direction of how, who, and when to treat us in our final days and hours. We can have documents drawn up to say what we want in the event we are in a state where we cannot voice our wishes aloud. These documents have legal and ethical basis, and they should be followed unless the legally or ethically unable to do so. Advance Directives gives a documented guide to the care giver’s or family member’s, so that they all can provide the kind of care that the medically impaired patient wants. This covers a wide variety of medical treatments such as dialisis, ventilators, feeding tubes and organ and or tissue transplants. If a patient has kidney failure they might or might not want to be on dialysis. The advance directive would spell out whether the patient would want such treatment if he or she was not able to convey this to the medical personnel. If the patient was at the end of life and did not want to be kept alive via artificial means such as a ventilator of feeding tube, the advance directive would have the patients wants of this type of treatment also. If the patient passed away and wanted his or her organs donated, then this directed would defanitely give the right to have their organs harvested and donated to someone in need. Even though there might be an advanced directed for a patient that is not able to express their wishes to their family or care givers, there can still...
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...non-voluntary or involuntary. Assisted suicide is committed by someone with assistance from another person usually in regard to someone suffering from a severe physical illness. It is referred to as a “physician assisted suicide” when a physician provides a competent, terminally ill patient with prescription for a lethal dose of medication upon the patient’s request. Physician assisted suicide is often confused with euthanasia. Do Not Resuscitate or “DNR” and Living Wills are legal orders that represent the wishes of a patient. A DNR states that the patient does not wish to undergo extra measures if their heart were to stop or if they were to stop breathing. A living will is also referred to as an advance health care directive, personal directive, advance directive, or advance decision. It is a set of written instructions that a person gives that specify what actions should be taken for their health, if they are no longer able to make decisions due to illness or incapacity. A DNR, Living Wills and various medical proxy documentations are legal when it comes to medical treatment decisions and the end of life. Euthanasia and physician-assisted suicide are prohibited in most countries worldwide. Belgium, Luxembourg, and The Netherlands appear to be the only countries where both euthanasia and physician assisted suicide have been made legal, but only beginning in 2001-2008. There are only four states in the U.S. (Oregon, Vermont, Montana and Washington) where physician assisted...
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...In today’s society it is very important when someone becomes ill or if something tragic happens to have an advanced directive for healthcare prepared to help their family make an ultimate decision regarding their life and health. “Advanced directives limit the type and amount of medical care and treatment that patients will receive if they should become incompetent and have a poor prognosis.” (Fremgen 313) With having an advanced directive it helps communicates a person’s wishes about making decisions if they become incapable of making their own health care decisions; which also makes it easier for family members to have everything planned out. Many make a decision and only tell their family what they want without having it in writing, but its best to have everything in writing for a smoother process. There are two important types of advance directives; a power of attorney or a living will. A durable power of attorney for healthcare “is a legal document that empowers another person (proxy) to make healthcare decisions for an incompetent patient. It goes into effect after the person becomes incompetent and only pertains to healthcare decisions”. (Fremgen 102) The power of attorney becomes effective when someone becomes incapable of making their own health care decisions. Medical power of attorneys covers a great amount of healthcare decisions based on the patient wishes. The power of attorney is capable of reviewing the patients’ medical records, discussing and questions...
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...The Patient Self-Determination Act of 1990 required consumers to be provided with informed consent, information about their right to make advance health care decisions. This act is also called advance directives. The act requires that patients be given information about state laws that impact legal choices in making health care decisions. Health care facilities in every state are required by this act to notify patients 18 or older of their right to have an advance directive in their medical records. Advanced directives include living wills; do not resuscitate (DNR) orders, medical power of attorney, health care proxy, or organ or tissue donation. Every patient must be informed in written form by health care facilities of the laws in their state that are related to advance directives. Every patient has to sign the advance directive notification form stating that they have been informed of their right to have advance directives. This provides proof for the facility that they have informed the patient. This form has made laws concerning patients right’s stricter. Records management procedures have had to make some changes to the way they do things in order to respond to this legislation. They have had to make sure when a patient comes to the hospital that they find out if they have advanced directives. Before this act this was not a question they asked when you came to the hospital. Doctor’s and the health care team have to pay closer attention to what the patient wants and do as...
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...In this paper, I will discuss advance directives, what it is, and the reason for it. I will talk about the issues that are currently facing advance directives care and talk about whether it has failed, or not. Finally, I will prove my stand on the issues with evidence. What is Advance Directives? An Advance directive is a living will, which allows one to document their wishes concerning medical treatments at the end of life. Even though it’s optional, but all health care facilities are required by law to ask patients if they have one, and offer them the appropriate information, and documents to sign if they want it. There are two basic kinds of advance directives, living wills, and durable powers of attorney for health care. Advance directives are legally valid throughout the United States, but the laws governing advance directives vary from state, to state. Anyone can have advance directives, no lawyer is required, and it becomes validas soon as you sign it in front of the required witnesses. Anyone can be a witness. Reasons for advance directives Advance directive is designed to empower patients, and to allow them to have a voice in their care. It provides a way for patients to communicate their wishes to family, friends and health care professionals, when they are no longer able to do so. With advance care directives, you can express how much, or how little care you want done for you when you are no longer able to make these decisions for yourself. You can also appoint...
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...disease will kill me.” Mr. Bailey’s family arrives and he discusses the above with his children. They openly discuss that if the O2 is removed he will die. The family is upset but supports his choice. The MD comes in and turns off the O2 and removes the nasal cannula. An hour and a half after the O2 is removed, Mr. Bailey dies. 1. Is this case unusual? Yes, he discusses that he wants to speak with the doctor about taking the Oxygen off, but there wasn’t a discussion with the doctor. 2. What is the Patient Self Determination Act? This act requires healthcare facilities that receive Medicare/Medicaid funding to inform their patients about their right to initiate an advance directive, and the right to consent to or refuse medical treatment. 3. Describe the purpose of 3 advanced directives (ex. Living Will, DPOA, Health Care Proxy) -A living will gives you some say in the medical decisions that must be made while you can't respond. It is the formal document that states your wishes for specific health care decisions to be made for you in the event you are unable to express them yourself. -The purpose of a Durable Power of Attorney (DPOA) is to give authority to someone else to act on your behalf if they were you. The person who holds a DPOA for all intents and purposes stands as if they were in your position and acts as your agent. -The Health Care Proxy Law gives you the power to...
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...Charlotte Cox Dr. M Butkus Philosophy 251-W1 13 July 2013 Where the Decision Lies Living wills are documents that define a patient’s medical wishes usually pertaining to life-support or any such instances where death is presumable. A living will provides a patient with a voice under circumstances which would leave them without the ability to make health decisions. Patients who fall into a persistently vegetative state would be at the mercy of their physician, next of kin, or living will. However, there are many times when a patient’s family has contradicting beliefs to what the patient proclaims in their living will. It can be difficult to decide whose decision should prevail. Ultimately, the previsions made by the patient in their living will should overrule in a majority of situations. Still, there are circumstances when such a decision may be unclear. First, we must understand the medical extent of someone who is in a persistently vegetative state. PVS is a disorder of consciousness and the patient is not in a state of trust awareness. PVS occurs when a patient loses cognitive function and can only perform certain involuntary actions. Such actions include but are not limited to crying, laughing, or movement of the eyes. For them, any movement or response is purely spontaneous, unpredictable and unconnected to events outside of physical impulse. After one year, it's highly unlikely that patients will emerge from their persistent vegetative state. For those who do, severe...
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...requires nursing homes, hospitals, home health agencies and HMO’s to provide information on advance directives at the time of admission. Under this law, health care institutions are required to provide a written summary of a person’s decision-making rights, which vary from state to state and provide in writing, the facility’s policies with respect to recognizing these advance directives (AmericanBar.org). The PSDA also requires health care institutions to ask the patient if he/she already has an advance directive and document it in the patient’s medical record. Health care institutions are also required to educate their staff about advance directives and not be discriminative against whether the patient does or does not have an advance directive. Advance directive is a legal document in which patients provide instructions on how they are to be treated in the event of becoming very ill with little to no hope for recovery (Green, M., & Bowie, M., 2005). A patient’s health care directive serves some of the purposes as a living will, but also encompasses others, as well. Since it is impossible to foresee every circumstance regarding a person’s health, a health care medical power of attorney is also needed to place someone in authority to weigh all medical facts and circumstances and carry out the patient’s wishes accordingly (AmericanBar.org). A health care advance directive combines the living will and medical power of attorney into one document, and may include...
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...identifies and designates your personal representative to make the medical decisions for you * You also need to talk to your doctor to make sure they are aware that you have a living will and discuss the details of the documents with them. * Why do we need an advance directive? Physicians used to subjectively decide for the patient, and the patient did not have autonomy, such as CPR for cardiac arrest. Now this decision making has shifted to the patient. * The Patient Self-Determination Act is a federal law that applies to all healthcare institution receiving Medicaid funds. This law requires those institutions to provide information about advance directives to adult patients upon their admission to the healthcare facility. Most family members, having not been in an ICU before, are not prepared to make decisions. Physicians have a sense of whether the patient in the ICU is going to live or die. Typically the family will prolong life until the physician tells them that they don’t think the patient will survive. (Navasky & O’Conner, 2010). * A living will can make your preferences known regarding end of life care. These situations can come up at any age. All adults should have an advance directive, which should be clearly written and witnessed. (Sabatino, 2007). * A durable power of attorney is not the same as authorizing someone to take care of finances. It is a legal document that allows another individual, your health care proxy, to make medical decisions...
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...The Purpose of a Living Will What is a Living Will? A Living Will can also be described as an Advance Directive in medical terminology. You will often hear Advance Directive in the health care setting. A Living Will is an “end-of-life” document that states your preferences for your care. This document has the ability to speak and make clear of things when you are not able to speak of it yourself. According to Rebecca Berlin, it’s a legal document that states “his or her wishes regarding life prolonging medical treatments” (Berlin, 2014, para. 1). Often times, individuals that have Living Wills went through a process of finding an attorney to prepare their documents. A Living Will is an area of estate planning. What are included in the estate planning package is the Living Will and a health care “Power of Attorney (POA)” (para. 2). A POA is also known as an individual who is the trusted advocate to be their voice when they are not able to speak for themselves. This is good to have in situations of not those who are terminally ill. Berlin states that “a Living Will describes certain life prolonging treatments. In brief words, it is what an individual wants and does not want to be applied in their terminal illnesses or permanent vegetative states (para. 3). Of course, these decisions stated in the Living Will are not in effect until an individual is unable to say for your treatment. Recommendations for ones dying and their loved ones It is not meant to be another person’s...
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...This course started with the end in mind and the future of health care. Life should begin by thinking of what you want your end to be. Children are taught about how life begins. With those teachings perhaps at a certain age young people should also have the talk about end of life decisions so that it is a process step wise as the go through life and start their own families. Explaining that “advance directives are simple tools that are morally neutral “but allow your voice to be heard at end of life is an empirical step to acceptance to this change in health care (Bustos, 2013, p. 244). This change would protect the family from dealing with legal issues amongst those in the family with objections to how plans are being carried out. The...
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... | |Flaws in Advance Directives, Living Wills, and Power of Attorney | Introduction A Living Will is a form of an advance directive that is a “legal document that describes those treatments an individual wishes or does not wish to receive should he or she becomes incapacitated and unable to make medical decisions” (Pazgar, 2007, p. 378). Normally in a Living Will an individual would also indicate another individual as his or her power of attorney in the legal document; however, it is not necessary for a living will to be created with a power of attorney or a power of attorney to be created with a living will though it is highly recommended to do so. This is due to the fact that each has its flaws and each could compensate for one another though in reality it could create more conflicts too. For a physician or any other healthcare provider to go against a patient’s autonomy means that there are many legal problems these physicians may face because they went against the patient’s desires, especially because of such allegations as criminal assault and battery. Advance directives have been created to preserve an individual’s autonomy and protect a physician from having...
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...Health care advance directives are documents that communicate a person's wishes about health care decisions in the event the person becomes incapable of making health care decisions. There are two basic kinds of advance directives: living wills and durable powers of attorney for health care. Durable powers of attorney are the legal basis during advance directives. Legal basis began when the Patient Self-Determination Act, a federal law was passed during 1991. This act requires that the patients are informed about their right to participate in health care decisions, including their right to have an advance directive.(Tonelli, 2008) Advance directives fall into two broad categories: instructive and proxy. Instructive directives allow for preferences regarding the provision of particular therapies or classes of therapies. Living wills are the most common examples of instructive directives, but other types of instructive directives, such as no transfusion and no CPR directives are also employed. The proxy directive, generally a Durable Power of Attorney for Health Care (DPAHC), allows for the designation of a surrogate medical decision maker of the patient's choosing. This surrogate decision maker makes medical care decisions for the patient in the event she is incapacitated. (Tonelli, 2008) The ethical basis for advance directives is pretty much dealing with living wills. A living will expresses a person's preferences for medical care it is called a “living" will because it...
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...Advanced Directive Questions 1. Which of the following is not true concerning an Advanced Directive? a. AD’s are a private manner and should not be discussed between patients and their HCP.*** b. Every person has a right to decide what will be done with his or her bodies. c. Health Care Providers should encourage the use of AD’s in older adult patients. d. All patients who are able to participate in conversation should be approached about their wishes and preferences in medical treatment. 2. What are the two types of Advanced Directives? e. Living will & DNR f. Healthcare proxy & durable power of attorney g. Living will & durable power of attorney*** h. DNR & durable power of attorney 3. What does DNR stand for? i. Do not resuscitate*** j. Do not rest k. Do not respirate l. Do not read 4. Which of the following is not true concerning a Living Will? m. The physician should be aware of the LW and have a copy. n. Only the patient should have a copy of the document.*** o. The LW should be reviewed periodically to make sure it still represents the patient’s current wishes. p. The document should be available on the patient’s chart. 5. A living will q. appoints someone to serve in case you can no longer make decisions. r. distributes your belongings to those who are still living when you pass away. s. provides specific...
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...In 1990 the Patient Self-Determination Act became effective. The Patient Self-Determination Act was an act that required consumers to be proved with informed consent, information about their right to make advance health care decisions, and information about state laws that impact legal choices in making health care decision. In North America, it is required that all health care facilities notify any patient 18 and over about their right to have an advance directive in their medical records. Living wills, health care proxy, and power of attorney are all included in advances directives. The patient must be notified, in writing, by the facility to any and all federal laws that are for advance directives for the state they are living in. I believe that this is very beneficial to both the patient and facility; as well as the patient medical records. If any problems were to occur during a procedure or surgery, the doctors and any medical personnel would know exactly what the patient would want. For example, my Grandfather had open heart surgery and he signed a DNR also known as a “do not resuscitate” just in case his heart would stop during his surgery, he did not want any type of CPR preformed on him to bring him back to life. People will all have different reasons behind why they choose to have a DNR. If something were to happen, and they did not perform CPR on a patient who was dying, they would have a living will so that all of the patients last wishes were...
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