Surrogate Consultants

A physician must understand that when it comes to deciding to withhold or withdraw life sustaining treatment it is ultimately the patient’s decision unless the patient is not competent enough to make this choice. I believe that a person can lose their life at any point. Death is certain and no one can run from it. In my opinion, a patient’s autonomy is of utmost importance anytime during healthcare however the physician can name some recommendations of what would be the best option for the patient. When it comes to patients they deserve to be treated with respect and ultimately be treated as an end not as a means to an end.

At any time a person can become incapacitated and unable to speak for themselves. “Cases come before the ethics committees around the country every day because people do not have advance directives in place, even though there was plenty of time and good reasons to engage in advance care planning” (Kottkamp, 2013). In many cases, the lack of advance care planning leads to a tragedy: families dealing not only with the grief of loved ones who are suddenly unable to communicate- and often near death- but also the heart break of trying to figure out who should make healthcare decisions and what those decisions should be (Kottkamp,2013). In most of these cases, this uncertainty could have been prevented with the simple act of executing an advance

Although the amount of research conducted is valid to the nature of the source, it is insufficient for in-depth study purposes. There are no official studies or other valid sources used in this article and a bibliography, naturally, is not provided.

Clinicians have observed that the DNR order set has a negative connotation and implies withholding or halting curative therapies (Venkat, 2014 ). As health care providers focus on the clinical aspect of care a dichotomy is created when the surrogate for the patient injects emotion into the thought process (Buscaino, 2013). They may perceive their choice to either be permission to terminate or agree to the DNR order to do “all that they can”. A study led by Ruth Wittmann-Price and Linda M. Celia, reported that a majority of physicians reported that they were personally likely to consent to AND for a

The data from this research study is clearly expressed, consistent and reflective of the data. There are primary sources cited in the article, and relevant landmark studies were described and used in this

A more recent case involving patient decision making when they are no longer able occurred in 2015 with Bobbi Kristina Brown. Bobbi died after spending half a year in a coma due to labor pneumonia. The main similarity between Bobbi’s and Terry’s case was the age of the patients. They were both adults which ended up in a vegetative state and unable to take the decisions for themselves. However, unlike in Terry’s case, Bobbi’s relatives were appointed to handle the decisions regarding her treatment. They gave a chance for Bobbi to recover before making the decision to remove the artificial feeding.

Death, dying and other ethical dilemmas are issues that all Intensive Care Units (ICUs) throughout the world have to face and address. In the Current Opinion in Critical Care, Vol 16, No 6, December 2010, p. 640, Dixon-Woods and Bosk, writing on the topic of “Death, dying and other ethical dilemmas” under the journal’s section of ‘Ethical, legal and organizational issues in the ICU’, have stated that “Recent ethnographic work suggests that ethical dilemmas associated with end-of-life care in ICU clearly persist, even if clinicians are now more open about patients’ chances of surviving. An Australian study identified how decisions and actions made

Near end of life, doctors face problems of withdrawing life-sustaining treatments or interventions. These interventions include such things as mechanical ventilation for chronic respiratory failure and dialysis for those in chronic renal failure. In some circumstances, these treatments are no longer of benefit, while in others the patient or family no longer want them. The physician plays an essential role in clarifying the goals of medical treatment, defining the care plan, initiating discussions about life-sustaining therapy, educating patients and families, helping them deliberate, making recommendations, and implementing the treatment plan. The physician must take the lead in initiating discussions about end of life care, educating patients

End of life decisions are very important because in some cases people lose the ability to provide informed consent for their medical treatment. If someone was unable to make his or her own health care decisions it becomes the responsibility of his or her designated surrogate. For example when someone is pronounced in a persistent vegetative state their health care surrogate would determine what kind of life prolonging procedures should be provided. During some point throughout a person’s lifetime it’s significant they make a Living Will that lists all of their intentions that will be respected by their family, friends and physicians. I chose to write about this topic because I recently created my own Living Will and had it signed by witnesses and documented incase I become incapacitated to express what treatment I want.

In 1995, a qualitative study conducted on healthy older adults evaluated the process participants underwent in their decision to obtain and execute advance directives (Crisp, 2007, p. 184). When asked to provide explanations for their decisions on having an advance directive, participants responded with fear of excessive use of technology to prolong life as well as fear of the subsequent loss of autonomy and dignity. Eight informants had also reported “An increase in their peace of mind or sense of relief and protection as a result of their decision” (Crisp, 2007, p. 186). In the absence of a living will or designated surrogate, an incapacitated patient may receive more than what is deemed appropriate and reasonable medical care. This loss of autonomy results in the patient suffering an unnecessary and prolonged course of treatment that is incompatible with his or her notion of human dignity and perspective on quality of life. Mandated advance directives helps to ensure that patients receive the end-of-life care they seek without the influence of family members or the health care team. The decisions made by the patient on a written document would also reflect their personal beliefs, values, and goals of care, thus providing patients with a sense of peace and

Another advantage of this report is its use of quantitative research. The selection of charts, tables and graphs are highly creditable in terms of measuring validity and reliability. It provides data with precise and non-bias numerical findings.

This is a subject is one that many people do not to talk or think about. However, it stares many people around the world in the face on a daily basis. It concerns determining when a loved one, who is on life support, is considered dead or alive despite the assisting machinery. In the majority of the cases, a person’s legal representative, usually a family member, is the one who make the choice whether to take a person off of life support. The doctor will give his or her recommendation and then it is up to the individual. There will always be opinions that contradict medical research regarding when a person is clinically dead. Removing someone from life support is no easy decision and no family member or medical person wants to make it.

The scholarly article I examined reinforces the importance of significant research evidence and how the strong desire to help people (beneficence) may lead to unintended harm (nonmaleficence). Moore, Rubin, & Halpern (2016) bring to light that while Physician Orders for Life-Sustaining Treatment (POLST) may assist in deterring unwanted medical intervention with legally valid physician orders, it may inhibit patient-centered decision making due to the broadened scope of medical treatment and expansion beyond the out-of-hospital setting (e.g., emergency departments; pp. 259–260). Furthermore, while there is a lack of research that demonstrates POLST programs enhance care for the dying, there is research (TRIAD VI & VII) that reveals health

End of life decisions are often not thought about until a serious illness or life event occurs. Specific treatment during the dying process may encompass simple to extremely complex decisions involving physical, legal, medical, spiritual, or psychosocial needs. Research shows that more than 75% of Americans have thought about their end of life wishes, but had not put those decisions in writing or designated someone on an advanced directive who would make decisions on

With major advancement in medical treatments, it is now possible to keep a patient alive, which would not have been possible in former times. This has made end of life issue one of the most controversial issues in healthcare. Medical improvements have set the stage for ethical and legal controversies about not only the patient’s rights but also the family’s rights and the medical profession’s proper role. It is critical that any decision made in such situation is ethical and legal to preserve the rights of the patient and also protect the healthcare institution involved. It is very important when making decisions to discontinue treatments to make sure all other alternatives have been explored.