Advance Directives Research Paper

The topic of end-of-life care may seem daunting and uncomfortable, and yet most individuals do have unique desires and concerns regarding their provision for the future. Providing the opportunity for that communication, the advance directive and POLST forms allow an individual to explicitly state their wishes before the future. Developed to lessen the apprehensions concerning patients undergoing any extensive and unwanted measures to preserve life at any cost, these medical directives lighten the decision-making burden for physicians and families alike and help comply with the patient’s utmost end-of-life wishes.

Advance Directives by the patient designates no feeding tubes, artificial ventilation, or CPR. Concerns regarding alteration of mental status consequential to his illness provoke the physician to seek consultation from the designated Power of Attorney. Nursing responsibilities compel the nurse to consider if the proposed actions of Dr. G violate the patient’s rights of self determination and confidentiality and prompt the nurse to advocate for the patient’s desires regarding medical treatment. Health care providers have a responsibility to honor the patient’s autonomy and provide quality medical care (Badger, 2009 p122). Providing artificial nutrition and ventilation transgresses the patient’s directives and is unethical. The physician appears to be asserting a paternalistic approach in deciding what is best for this patient. Should the interventions be temporary and provide resolution of the condition, the physician can defend his actions as being healing and beneficial. However, there is a chance that the interventions may be permanent and futile; avoiding passive euthanasia and terminal dehydration, serving only to prolonging the illness. Violating the patient’s directives of care by performing invasive procedures can lead to legal incriminations of assault and battery.

Figure 1 displays each state within the United States and which form of advanced directive they have adopted into their individual state’s laws. Utah is one of twenty-eight states which have implemented an advanced health care directive with both a living will and a durable power of attorney for health care. In the state of Utah advanced health care directive is defined as “a designation of an agent to make health care decisions for an adult when the adult cannot make or communicate health care decisions; or an expression of preferences about health care decisions” (le.utah.gov). Agent is defined as “a person designated in an advance health care directive to make health care decisions for the declarant (le.utah.gov).” An individual has the right to not appoint and agent on Utah advanced health care directive forms as well (le.utah.gov).

The other part of an advance directive is the durable power of attorney. One’s proxy, who carries the durable power of attorney, should be a trusted relative or friend that can make decisions for a patient if the patient is incapable of doing so themselves. The patient should speak in depth with the proxy about their wishes overall and, if specific situations were to arise, how to proceed. A proxy that is trusted is a great resource should the unfortunate arise; they are able to speak out and advocate for a patient, as well as elaborating on certain written decisions. Having a proxy is especially beneficial if a patient is incapacitated and in a situation that is not clearly covered by a living will (Roberts, 2001).

When you are able, you should put thought into the physical process you will go through. All of us love you and want to make sure that when the time comes, we know and can follow your wishes regarding the care you wish to receive. Having your decisions thoroughly and clearly stated in an advance directive will make this possible. (Berger, 2014, p. 590). Your advance directive document may contain a living will, a signed consent for Do Not Resuscitate (DNR), and information identifying your healthcare proxy. Understanding these things now, will help you make clear choices. A living will clarifies what care, or lack of care, you wish to have (Berger, 2014, p. 590). This is helpful for reference if you are ever unconscious or in any way incapable

What is your understanding on Patient Self-determination Act? Explain. What is the advance directive process used in your organization?

Within the past ten years, multiple studies have been conducted regarding the completion rates of advance directives. Topics discussed include structure, evolution, benefits and challenges of advance directives (Perkins, 2007; Castillo, Hooper, Sabatino, Weithermon & Sudore, 2011; Cohen, MCannon, Edgman-Levitan & Kormos, 2010; Halpern et. all, 2013; Johnson, Zhao, Newby & Granger, 2012;Later & King, 2007; Mickelsen, Bernstein, Marshal & Miles, 2013; Yoo, Nakagawa & Kim, 2013; Waite et. all, 2013; Watson, 2010). Through initial research the same articles also provided possible solutions and recommendations that could be used to improve advance directives education procedures. However, the data did not provide a guideline that instructed how to conduct patient education procedures for advance directives. Therefore, the discovered data will be used to develop a possible guideline.

Tennessee law on advanced directives is a document that tells your family, friends, and doctors on how you want to be treated in an emergency. Advance directive can be a document or a living will in which you state the plan of care when you are no longer able to communicate treatment choices or decision. Advance directives is not only for the elderly but it can be at any age even if you are not sick at the time of the document. This document list the details of treatment that you want implemented if a serious incident was to happen. It would tell what interventions should be used in your care. Some of the choices would include a full status code where the patient wants CPR or a do not resistant code can be used for treatment. The client can also have the option of limited interventions with each code status. It would include artificial ventilation or artificial feeding and any type of tubes associated with your treatment. The client can also be specific if he or she wants just medical treatment only including the use of drug therapy. In this paper, we will look at Tennessee law and various

Advanced directives (ADs) are an effective method of communicating one’s preferences for end of life care, but they are often underutilized.

It is critical for people to recognize the importance of obtaining a living will or a Medical Power of Attorney before a health concern occurs. Since the health of an individual can never be predicted because of unseen accidents and conditions that can arise it is imperative to make this a priority. Thanks to the “Patient Self-Determination Act of 1990” it is now a priority for a health facility to obtain an advance directive from a patient before care is given (Goede & Wheeler, 2015). However, relying on the probability that a patient will enter into a health facility in a state of good health is unpredictable. To assure that a patient’s autonomy is being respected in the medical decision-making process obtaining a living will or a Medical

Advance Directives—research and discuss the legal and ethical basis for Advance Directives such as the Living Will and Durable Power of Attorney for Healthcare. Why are these documents so valuable in healthcare situations? What legal authority do these documents provide for decision making by family and/or healthcare providers? Briefly discuss a situation in which a Living Will might apply and would be of benefit to those involved. Once you have researched and discussed Advance Directives, draft a sample Living Will, indicating the type of content that should be found in such a document. Some students take this opportunity to prepare their own actual Living Will, and that certainly is encouraged.

The use of a form of Advance directives dates back as far as 1914, in where case law established the requirement to obtain a patients’ consent for invasive medical procedures, based on the right of self-determination (U.S. Department of Health and Human Services, 2008). It was not until the late 1960’s that Advance directives began to be developed in the United States. Patient and consumer rights movements sought legal measures through state and federal actions to alleviate the use of aggressive and ineffective life-sustaining treatment with the living will, the known as the earliest form of an advance directive (U.S. Department of Health and Human Services, 2008). In 1976, the Natural Death Act in California, “was the first law to give

This film explains the legal role of advance directives in end of life issues. An advance directive is “a written document directing how medical decisions are to be made in the future when the patient lacks decisional capacity and is unable to decide and choose” (Hanlon, End of Life Issues, Slide 28, Bullet 1). All three of the cases demonstrate the importance in filling out some form of directive. When there is nothing to go off of, it makes decisions extremely tough for families and medical providers. Having legal documentation of patient wishes helps understand what treatments they would or would not consent to. In cases like

The Patient Self-Determination act requires all health care facilities that receive Medicare or Medicaid funds of his or her right to make decisions. This is vital to inform those which states give certain patients the opportunity to receive self-assisted suicide if need be. The act also required patients to provide information and assistance to prepare advance directives. Advance directives are legal documents that state what medical treatments are necessary in the event the patient becomes incapacitated and are unable to indicate their wishes regarding medical care. States pass these acts that allow

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.