Nursing Roles and Values

Each human being will reach a stage in life where death and separation are inevitable. Consequently, it is important for each individual to be able to foresee what the future will behold especially when death can occur unexpectedly or subsequently after chronic illnesses. The British Columbia Ministry of Health (2013) states that developing an advance directive ensures that families, and members of the interdisciplinary team acknowledge the individual’s own health care decisions, and carry their own wishes in an event where the individual may be deemed incapable (p. 3). Furthermore, it gives the individual the autonomy to make decisions in advance for themselves for situations such as an irreversible coma due to decrease oxygen perfusion to

The chief ethical implication is the violation of the patient’s desire to not be intubated and go on the ventilator. The patient has an advanced directive, a legal document, which clearly states that he does not want to be on a ventilator. The patient does not appear to have changed his mind since the document was drawn up, as evidenced by the patient shaking his head and stating “no” when confronted with the physician’s desire to place the patient on the respirator.

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

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

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

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

As stated by Goodwyn (2014), “It would have been hard to find a happier man than Erick Munoz on that Tuesday morning before Thanksgiving” (para. 1). Marlise Munoz was a 33-year old woman who had brain death because of a possible blood clot in her lungs on November 26. Marlise was pregnant at the time of her death and after her husband found her unconscious on the kitchen floor, she was hospitalized in John Peter Smith Hospital in Fort Worth Texas (Goodwyn, 2014, The Strange Case…). Significantly, the family had expressed that Marlise desire was to not bee keep alive by the use of machines, however, the patient did not leave a written directive regarding her end-of-life care. On the other side, the hospital refused to withdraw the life-sustaining treatment from Marlise because of a provision from the advance directive law of Texas, that cites “A person may not withdraw or withhold life-sustaining treatment…from a pregnant patient” (“Advance Directives Act”, n.d.). Consequently, the family sued the hospital and after two months of suffering for the family, the judge ordered to withdraw any life-sustaining treatment from Marlise.

As a member of the hospice ethics committee, we realized that this is a decision of John’s choice. We would have to evaluate his legal rights, the Georgia Euthanasia Laws, and to make sure his DNR, which is, “one common request made by dying patients is a “do not resuscitate”; and his living will be up-to-date for his family. A living will, “the kinds of treatments they desire and, more important, the ones they do not. This is called an advance directive and is sometimes referred to as a living will” (Rae, S. B., 2009, p. 215). Consequently, John also needs to verify his agreement that he had preferred an “extraordinary mean,” are those that do not offer such hope and place undue burdens on the patient” (Rae, s. B., 2009, p. 214). To evaluate

This patient’s Living Will is not going to be helpful in this situation. Living Wills use undescriptive words such as “terminal” or “reasonable” that are too general to define appropriate healthcare actions, making the Intern’s argument effectively pointless. As the patient does not have a more appropriate Advance Directive, we would need to determine the patient’s decision maker.

In my grandfathers advanced care directive, his wish was to not be resuscitated if he was to code. He wanted to be on life support, but left the final decision to my grandmother. The family came to the consensus that we are only keeping him alive for our sake and it’s not fair to anyone anymore. It wasn’t easy, but we made the decision to take him of life support on the early afternoon of April 21, 2009. He was a fighter, and fought till the last second of his life. It wasn’t until April 22, 2009 in the early morning hours that his body it’s all.

The importance of advanced directives has grown throughout the years with an increasing recognition of patients’ autonomy and the realization that while advanced medical technologies have contributed to many health care benefits; these same advances have brought on the unacceptable prolongation of the dying process for many (Evans et al 2011).

However, there is sometimes circumstance when a living will, advance directive, nor a power of attorney is established, and the individual is unable to express their wishes regarding the way their medical care is facilitated. In this case, another individual makes the decision. The other individual’s decision can be contrary to your

Today, 80-85% of Americans die in medical institutions. Of those, 70% require decisions about whether to apply, withhold, or withdraw medical treatment (Makar 58). Due to this ever increasing number, the right to die is one of the most popular and controversial topics in medicine today. The issue comes down to personal beliefs and ethics and the fact that there is so little clear-cut legislation on this topic confuses it even more. Advance Directives provide, in theory, for self-determination and put the patients mind at ease with the knowledge that they have decided for themselves the extent of health care that they wish to receive. Also, for the family, the process of watching their

When you think of it that way, there should be no question, but things are often much more complicated than that. As stated, many people often do not take into consideration their own mortality and therefore never made arrangements beforehand on what to do if this situation occurs. In this case patients are left to suddenly make decisions about their health they never thought they would have to. In the event that the patient is unable to state their wishes, then the decisions get passed on to whoever holds healthcare power of attorney (your “agent”). It is important that whoever holds power of attorney is well informed about what the patient’s wishes would be in any critical scenario, because, “generally, the law requires your agent to make the same medical decisions that you would have made, if possible” (caringinfo.org).

Its purpose it to designate a health care agent, provide a living will, and provide a place for the sick person to communicate preferences on other matters, such as feeding tubes. It is different from a Do Not Resuscitate order (DNR) in that a DNR must be filled out and signed with the person’s physician. In order to properly complete an Advanced Directive (AD), the person must have two witnesses who are not related by blood, marriage, or adoption and cannot be or be connected with the patient’s personal healthcare professionals. The Living Will must also be notarized. While there are specifications for the people who can witness this document, there are fewer for the healthcare agent. This person must be eighteen or older, in sound mind, and able to execute the responsibilities of the role. When the patient’s physician and another physician determine that the patient is no longer able to make his or her own decisions, the agent steps into the picture and the AD goes into effect. Knowing the purpose and process behind an AD sheds light on the important role it plays in the last days and weeks of a person’s life.