Advanced Directives

Patient informed consent refers to the situation where the patient is fully informed on the consequences of their health care decision after which the patient gives the decision. For there to be informed consent, there are five elements that must be discussed. The first is the nature of the patient's decision then the applicable alternatives to the proposed intervention. Third are the risks, benefits and uncertainties associated with each of the alternatives. Fourth is the assessment of the patient's understanding and last is the acceptance of the intervention or an alternative by the patient. Before the patient's consent is considered to be valid, the patient's competency to make the decision must be addressed. The criteria for evaluating the patient's competency is clearly stated in section 3 of the 2005 Mental Capacity Act which states that provided the person is able to understand, retain and use information provided and to communicate their decision in any way such as talking or sign language, they are competent to make a decision. If a patient is treated against their refusal to consent, it amounts to the tort of battery or can also be considered the crime of assault. In addition to this, laws that touch on human rights reinforce the importance of the protection of the physical integrity of the individual in terms of their right to respect of their private life. Therefore, refusal of medical treatment is a human right.

I must be aware, as the patient’s advocate, of the choice of each individual patient regarding his or her medical management or, as in this case, the withholding of treatment.

The Dax’s case study presents convincing evidence to consider and legalize the right to refuse life-sustaining treatment and the right to die. Patients, as under the informed consent have a right to make the decisions about their medical treatment (Harris, 2008, p. 198). Consequently, the Dax’s case has reasonable facts to believe with regards to informed consent that as a competent patient he is qualified and be given free choice over his life.

“The final moments of one’s life are difficult for everyone involved-the patient, loved ones, and even the healthcare provider” (Klein, 2005). If a patient’s final wishes regarding his/her care are undefined or not clear, then the situation could be worse or uncomfortable. During what should be a time of caring, mourning and supporting one another can quickly become overshadowed by ethical and legal battles. However, this can be prevented and avoided by the execution of advanced directives.

Suffering is a constant companion of humans today; people experience it every day, whether it be emotional or physical, internal or external. Living with a terminal illness is also living with suffering, both because of the physical pain that is felt, and also the emotional blows the patient experiences every day. A terminally ill patient has a monumental part of their life taken from them. Few aspects of life still remain in their control, because of doctors, family members, and the illness itself. However, there is a practice that places a final decision, the right to choose the circumstances of death, with the patient. Physician-assisted suicide (PAS), or physician

I do not want my life to be prolonged if (1) I have an incurable and irreversible condition that will result in my death within a relatively short time, (2) I become unconscious and, to a reasonable degree of medical certainty, I will not regain consciousness, or (3) the likely risks and burdens of treatment would outweigh the expected benefits.

As a result, this challenges the ethical principles of autonomy, beneficence and nonmaleficence. At some point in our lives, we will be a patient in one way or another. As patients, we have the legal right to decide what’s in our best interest when it comes to the management of our health. The concept of autonomy is centered on the idea of self-governance. This means that patients have the right to play an active role in their treatment and medical care plan and have the right to receive or refuse treatment, the right to confidentiality, the right to select a healthcare proxy and the right for informed consent.

I further direct the treatment be limited to measures to keep me comfortable to relieve pain. These directions express my legal right to refuse treatment. Therefore I expect my family, doctors, and everyone concerned with my care to regard themselves as legally and morally bound to act in accord with my wishes, and in so doing be free of any legal liability for having followed my directions.

Every human that is born on this planet will eventually have to die. No one is above this universal truth. A typical healthy man or woman is expected to live 79 years (Pew, 2013). However, events sometimes evolve and the quality of life can decline quickly and unexpectedly. In life, death is always approaching and elderly people in America need to be better prepared for the inevitable; however, advanced directives, palliative care and other end of life decisions are important choices that shouldn't fall on uneducated shoulders. There should be a system in place to help comfort them when the time comes.

Often times when a terminal patient has six months to live they still have autonomy. One would need to be autonomous to be approved for PAS and as such we can infer that the patient is able to make peace, tie up loose ends, find comfort in religion, and be comforted with family before being consumed by the disease. Giving the patient the option to die with dignity vs. naturally where time and treatments slowly deteriorate the mind and body can offer freedom from suffering for the patient and family. For example if a patient that felt ill and after medical testing receives a diagnosis that she has a rare systemic cancer and at best has six months to live. That patient then could with the support of her family discuss everything that needs to be taken care of prior to the advancement of the disease. After taking care of business, the patient could discuss with her family and friends ways to create special days leading up to her last day. This option could give the family, as well as the patient, the possibility to say goodbye before the disease has removed autonomy and personality. This patient’s family would not have to watch their daughter, wife, sister, or mother suffer greatly to the point she screams for God to take her.

I believe that a person should have the independence and freedom to decide their fate, as long as it doesn’t cause harm on others such as family, friends, and the doctors involved. Because of the rapid and dramatic developments in medicine and technology in today’s society, it has given us the power to to save more lives, yet prolong the death of the patients whose physical and mental capabilities cannot be

Patients with severe illness can deteriorate, become physically or mentally impaired and be unable to make or communicate healthcare decisions. Modern healthcare can prolong life, but this may result in prolonged pain and suffering or reduced quality of life. Moreover, some patients, due to experience, religious views, cultural views or advice from family and friends, may want to deny some future treatments that they receive or request for others. In such situations, the Advance Health Directive (AHD) document can come into effect and be used by patients to express their healthcare directions.(1) An AHD is a legal document, which is a form of living will, in which a patient can

Death and dying has changed drastically in the past hundred years. In the past, most deaths occurred without warning mostly due to infectious diseases. Back then, medicine could do little to cure illness or extend life (NCBI, 1997). Most deaths occurred in the home surrounded by family. Today, death usually happens to older people following a long-term illness. The dying patient is usually in a hospital or heath care institution of some kind (Carr, 2003). The dying process is now more controlled by the ill patient and their family (Carr, 2003). “The Patient Self Determination Act, passed by Congress in 1990, requires all government-funded health providers to give patients the opportunity to formally articulate their end of life treatment

Patients want to be able to control some factors of their lives. They should be able to choose when they want to pass. Some patients may want to live longer for their families, others may not have any family or just choose to leave early. There are so many reasons to why a patient would want to stay or go. Letting the patients have some control over their lives may help them gain some comfort. Helping the patients live out the rest of their lives their way is necessary.

Although my family has trouble talking about advanced care planning, I have felt strongly about this topic ever since I became interested in health care. I feel that its so important for everyone to have their wishes, at the very least, verbalized to their loved ones. I feel that planning for end of life when you are in an unaltered mental state/physical state is pertinent to having the most accurate wishes expressed! I have verbally expressed my wishes, however I feel that I will soon have mine expressed in a concrete way, such as an Advanced Directive form. I wasn’t explicitly educated on this topic until I took my Bioethics course during my sophomore year here at Mount Saint Mary’s. I immediately went home and told my mom about how passionate