DPOA Case Study

After reading your post and many of the colleague in the class, most agree that is not professional to disregard the conversation that the family was having. Although the patient wishes were not to remain on life support and had a document to prove it he also fail to have a proxy to carry one his whishes. The Health Care Proxy is a simple document, legally valid in many states, which allows a person to name someone (an "agent") to make health care decisions their behalf if they are unable to make or communicate those decisions. (Society, 2015).

Hello all, my name is David Jamison, MHA. I am representing Marion General Hospital as the committee chairman of the ethics committee. I am currently reviewing the case involving female patient Margie Whitson. The patient is a 95 year old patient whom wishes to have her pace maker “turned off”, due to her unwillingness to live. The death of her only remaining son was the last event that, that had forced her to contemplate the reason why she still lives. Mrs. Margie Whitson is no stranger to loss. When she was younger, she lost her youngest son to a severe motor vehicle accident that took his life at the early age of 30. She injured herself over 10 years ago, and received a hip fracture. Her most recently bout was

It is even worse when one is forced to make painful decisions about ending the support system provided by the health care facility due to prolonged stay in a coma. Advanced directive plays a major role in easing the burden off from the loved ones, when faced with the terrible consequences. Medlineplus (2016), states that the advance directives are legal documents that allow an individual to make decisions about the end-of-life care ahead of time. Examples of Advanced directive are: durable power of attorney, designating a health care proxy, and living will, legally documented for treatment option if one is dying or permanently unconscious.. It also important to have the legal document to the right place, when a decision needed to be made. Advances directive is controversial when it comes to religion, tradition regarding the dying close families, friends and also, physicians. Although the advance technology has positive aspects in extending life longer, at the same time leave us dependent on others, unable to make decisions and in great pain too (Advances directive,2016)

Any situation that erupts which can disturb the other residents is something that must be diffused immediately, as a healthcare administrator I would have to address this state of affairs with empathy and genuine concern for the opinions of the family members not in agreement with the do not resuscitate (DNR) order. First, I would ask that we move to a private location where we could speak and if voices are elevated it would not interfere with the day to day operation of the nursing home. Second, I would ask to see the Power of Attorney if it is available to speak to the legality of the document. Provided that, all the previous terms set in place are up to par, I would directly talk about the statement made about the family member making me aware of her position with the Department of Health and Human Services. Moreover, going through the document to point out the date signed, to make note if the new resident signed it before here memory was too far gone and if the Power of Attorney would not be substantial. Then I’d call attention to the difference between a Power of Attorney and Durable Power of Attorney. Grammarly states, “The biggest difference is in when the power ends. A general power of attorney ends when a person becomes mentally incapable because of sickness or injury to handle his or her own affairs… To get a durable power of attorney, you must show in the

A patient barrier might include having limited knowledge surrounding life-support systems and treatment options, thereby hindering their ability to fully comprehend or demand certain interventions. Good counseling is therefore essential to overcoming this barrier in implementing the patient’s true and best wishes (Kroning, 2014, p. 222). Another barrier in implementing advance directives concerns the role and influence of family members and the patient. There may be discordance between the desires of the patient and family, which can result in serious debate and tension if not addressed and taken into consideration. Physicians still may have reservations, as certain demands made by the patient may raise ethical concerns in the future, if the provider feels the interventions being done are no longer medically appropriate.

CCIB Intake received a call from resident Eugene Kunz DOB 2/8/24 in room #6. Mr. Kunz call to state he wanted to remove his daughter Joyce as his Power of Attorney (POA) and pay his $3000 rent each month. According to the caller he has residing in the facility for approximately 3 1/2 years and wanted to return to his home, however due to his slight dementia he was having difficulty with his memory and therefore could not return to his home. Conversely the caller described how his daughter would have him examined by physician who would give him 3 words at the beginning of his examination and at the end would ask him the 3 words. Unfortunately the caller could never recall the 3 words and thus was unable to return to his home. Recently the caller

Every seriously ill patient and their family should have decided the following issues: proxy, resuscitation, hospitalization, and specific treatments. Every seriously ill person needs to have pointed out a person to speak on their behalf when they get too sick to do so. A “proxy” can be filled out at any hospital or nursing home granting “power of attorney” to a loved one to be able to make decisions. A person

SC, Jennifer Stoker met face to face with Christopher for his Annual PDP meeting at his Day Hab in Dallas, TX.S SC was welcomed into the home by caregiver staff, Joel. SC observed Christopher siting in his wheelchair. He was awake and very alert. He was in a good mood and relaxed. He looked clean and comfortable. His provider, Rose Msewe, and SC Christian Gray Hering was present. Rose renewed his IPC during the meeting. SC discussed his HCS Rights and Consents with him. The following forms were explain to Christopher but he was unable to sign them: Authorization to Disclose Information, Verification of Receipt of Rights, Verification of IPC Services Request, Consent For Services, Your Rights in Local Authority Services Handbook, Your Rights

The DPS has an adverse selection problem and is significantly over capitalized and over-administered for its declining student population.

DWDA allows terminally ill residents to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose. The law states that, in order to participate, the patient must meet strict criteria to be able to request to participate in the Act. The patient must make two oral requests to the attending physician, separated by at least 15 days and the patient must also provide a written request to the attending physician that is signed in the presence of two witnesses (at least one of whom is not related to the patient). Once these steps have been completed the attending physician and a consulting physician must confirm the patient's diagnosis and prognosis and determine whether the

In the events of the shootings of Dallas Police Department by Micah Xavier Johnson, the DPD released and operated a robot attached with an explosive that went in and was triggered to exploded near Johnson. This action was done to end the multiple hours of gunfire between the officers and Johnson. This has now formed a debate regarding the ethics of using this form of deadly force. I believe that the DPD was correct and ethical in using this tactic for the reason that using this robot prevented hours of gunfire and possibly saved the lives of officers engaged in the gunfire between them and the shooter. Even though it’s a new irregular way to subdue the suspect with deadly force, it’s purpose to end the hour of violence and prevent any other

Ethical dilemma may also arise in cases where a patient may feel their right to DNR should be carried out when giving direct order. The DNR process, however, is required to be documented by a physician. Andrew Putnam (2003) presents a case where an eighty-eight year old patient’s code status was DNR; “However, the patient has never signed formal advance directive statement or assigned durable power of attorney for her health care to anyone.” (Putnam, 2003, 2025) Ethics can be simply stated as doing the right thing (Roberts, 2002, 242); but in this case ethics is questioned because the physician was faced with the decision to carry out the wishes of the patient or to make a decision based on legality. In this case, it may have been morally right to carry out the wishes of the patient who wanted DNR orders carried out, but it may have been the right choice to do the legal thing and not carried out due to lack of signed documentation.

Petitioner Nancy Cruzan is incompetent, having sustained severe injuries in an automobile accident, and now lies in a Missouri state hospital in what is referred to as a persistent vegetative state: generally, a condition in which a person exhibits motor reflexes but evinces no indications of significant cognitive function. The State is bearing the cost of her care. Hospital employees refused, without court approval, to honor the request of Cruzan's parents, co-petitioners here, to terminate her artificial nutrition and hydration, since that would result in death. A state trial court authorized the termination, finding that a person in Cruzan's condition has a fundamental right under

Mrs. Green, who has been diagnosed with kossakoff dementia, has been admitted to the maple ward. She needs 24-hour personal care and assistance. She is independently mobile but has to be reoriented to her location constantly. Several times a day she has to be reminded that she is in a hospital. Mrs. Green has to be prompted and encouraged to eat and intake liquids. As a result of this poor intake, she has been referred to a dietitian. She is also being monitored via a chart for her food and fluid intake. Mrs. Green becomes restless and agitated sometimes, but she has requested to leave the ward on a number of times and has even tried following family and staff out of the facility. If she has the chance, she will leave the ward. Furthermore, she also invades the personal space of other patients, some of who have acted aggressively towards her. Mrs. Green isn't fully aware of her surroundings and requires 24-hour support and intervention. Her medication is administered by a registered nurse and she is compliant with this procedure. Mrs. Green has a short memory span and is disoriented to person, place and time. Her assessment shows that she doesn't have the capacity to consent to be admitted and treated.

However, as law evolves so do businesses where they use an alternative method known as diverted tax profit, DPT. It has a similar structure or process of transfer pricing, instead engaging with their subsidiary companies, it is accomplished through an agreement with a foreign entity that resides in a country. Thus, in Australia, the parliament enforced a new Tax Law Amendment (Combating Multinational Tax Avoidance) Act 2017, No 52, which targets specifically on DPT that supplements to Multinational Anti-Avoidance Law (MAAL). According to Les Nielson (2016) of the parliament, the new law commenced on 1 July 2017, that imposing tax rate 40% instead of 30% corporate tax rate to multinational companies that generate a global revenue of $1