Health Care Legislation

A person’s life can end at any age. They can depart quickly or slowly. End of life care, also known as palliative care, is the care of patients that are not only in their final hours or days but the patients with a terminal illness that has become incurable. End of life care takes into mind what the patient desires so it is recommended that they consider an advanced care plan also known as an advance directive and living will. These documents allow the patient to formulate decisions on the future of their care if, at any point, they cannot vocally express themselves.

Secondly, the patient should be capable of making and communicating health care decisions for him or herself. Thirdly, the patient must be diagnosed with a terminal illness that will lead to death within six months.  Interested patients must also provide the request for termination in writing to the physician. In addition, physicians are expected to inform patients to alternative means of care including hospice care and other medications. Only after precautions evaluation, the laws then permit patients to make the ultimate life ending decision.

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.

On a living will, an individual can express if they would prefer not to be resuscitated or if they don’t want to be living artificially on life-support. Additionally, living wills establish a written declaration of a power of attorney, establishing a person who may legally speak on behalf of a patient who is unable to do so. Living wills are crucial pieces of documentation that are necessary for the dignity and wishes of a person who may fall unexpectedly into a life-threatening condition. If a person does not wish to live artificially on life support, a living will may be the only documentation that can secure their right to die with what they choose to be a dignified death. Unfortunately, living wills are not too common, resulting in countless Americans whose lives are extended long after they wish to live. In order to get a living will, one can either hire an attorney and have the attorney draft a living will or there are templates available that can be filled out and submitted for notarization.

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

This declaration and the following directions are an expression of my legal right to refuse medical care and treatment. I expect and trust the above-mentioned parties to regard them as legally and morally bound to act in accordance with my wishes, desires, and preferences. The above-mentioned parties should therefore be free from any legal liabilities for having followed this declaration and the directions that it contains.

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.

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

Advanced directives have received increasing advocacy over the past 20 years. High profile cases, the Joint Commission on Accreditation of Healthcare Organization (JCAHO) and the Patient Self-Determination Act

There are two types of advance directives: a Living Will and the Durable Power of Attorney for Health Care. A Living Will requires a witness or be notarized and consists of a directive that instruct the acting physicians to not utilize medical interventions in an instance that the patient is unable to make their immediate medical decision. The Living Will is the oldest form of advanced directives, requires a patient be terminally ill and it states that its interpretation is only to be assumed by the patient and their physician, there is never to be any family influence or interpretation of a Living Will. Durable Power of Attorney for Health Care is also witnessed or notarized and identifies an ‘agent’ to make health care decisions if the signer is unable to make their own decision. An agent is an individual that the patient chooses with great care, due to the amount of power/authority that is assumed to making such decisions. The Durable Power of Attorney does not require that a patient be terminally ill and is interpreted by the identified ‘agent’. There have also been known to be hybrid documents that combine elements of a Living Will and Durable Power of Attorney for Health Care that acts as an Advanced Directive. (Advanced Directives.,

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

This is illustrated in Mrs. Smith’s case. Mrs. Smith is an 85 year old who has suffered from a large stroke that extends to both of her brain hemispheres which has left her unconscious and unable to make medical decisions for herself. She only has some brain stem reflexes and requires a ventilator for life support. Mrs. Smith did not set up an advanced directive, which is defined by Miracle (2011) “mechanism by which individuals make known how they want medical treatment decisions made when they can no longer make them for themselves” (p.229). Without an advanced directive, medical decisions will fall to Mrs. Smith’s children, Sara and Frank. Each of which have different views regarding their mother’s plan of care. The decision that needs to be made is whether to prolong Mrs. Smith’s life with continued medical intervention, as Sara would like to do, or stop all treatments and care, as Frank

With an increasing aging population and growing numbers of individuals with chronic conditions, it is important for individuals to prepare for end-of-life care. An Advance Directive is a defined as a “legal document that provides data to critical care staff about patients’ wishes, especially when critical illness decreases decision-making ability” (McAdam, Stotts, Padilla, and Puntillo, 2005). An Advance Directive also allows for better communication between the patient and doctor, and preserves the autonomy of patients. It may also alleviate one’s family from any possible burden of uncertainty of one’s wishes. It provides guidance, which may avert arguments with family members concerning treatment choices (Cedars Sinai, 2015). The Patient

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.

The advance directive, or living will, is one way of circumventing the ethical dilemma of Quinlan, as it is essentially a set of choices by the competent patient if faced with different hypothetical circumstances. Patients can thus feel comfortable knowing that their competent wishes have been documented and can be easily interpreted in case of catastrophe. However, the authority of advance directives is a topic hotly debated amongst medical ethicists (see Advance Directive Authority). Arguments against directives state that not all factors are considered by the person creating the advance order. Also, in some cases of severe dementia, it is argued that the personal identity of the author is no longer intact and therefore has no authority over the treatment of the “new” person. The debate on this topic is extremely complex, but many of today’s cases are decided on an individual basis, with the directive often being upheld.