The Role Of Decision Making In American Culture

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.

.“As medical technology continues to advance and health care choices become more complicated, the preservation of end-of-life autonomy is an increasingly important issue faced by various client populations.” (Galambos, 1998).

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.

It is also clear that while making these decisions, the decisions ought to be made based on informed consent (Werth and Crow 195). Sometime, the patient may be experiencing dementia, clinical depression or delirium for which they may be affecting the patient’s decision making capabilities (Werth and Crow 197, 198). If such a person is allowed to make their right-to-die decision, this may be done without the patient having comprehensive information before consent and thus should not be encouraged (Werth and Crow 198).

In the US state laws allow a person to make decisions when it comes to their own healthcare. Most states are different but all include a Power of Attorney or Medical Power of Attorney and a Living Will. Power of attorney allows a person to give another person the power to make decisions when the persons healthcare. Living Will is a document that is in writing that explains what medical treatment a person wants if they are unable to express it.

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

It is critical for people to recognize the importance of obtaining a living will or a Medical Power of Attorney before a health concern occurs. Since the health of an individual can never be predicted because of unseen accidents and conditions that can arise it is imperative to make this a priority. Thanks to the “Patient Self-Determination Act of 1990” it is now a priority for a health facility to obtain an advance directive from a patient before care is given (Goede & Wheeler, 2015). However, relying on the probability that a patient will enter into a health facility in a state of good health is unpredictable. To assure that a patient’s autonomy is being respected in the medical decision-making process obtaining a living will or a Medical

There are occasions when medicine is not your friend and the effects of the treatment will only prolong the suffering of the patient. Healthcare professionals must be objective and ask will the end result be changed. We must know when it is appropriate to discuss end of life options and when it is not. According to Adams (2015), most desire to die at home, but less than half are allowed to do so (p. 13). Our responsibility is to allow the client to make an educated decision about all the available service and treatments.

The terminally ill think about not only their life but how their decisions will impact their family after passing. They turn this fear of disappointment into a burdensome feeling which make them feel as if they family does not want to take care of them or take on their issues. Studies conducted by the NCBI, in “Patients’ Experiences of Being a Burden on Family in Terminal Illness” show how when asking participants about end of life care their response was they “wanted to feel that they were not being a burden on family or society was one of the eight factors rated as important by most patients but not seen as important by most of the doctors.” By allowing patients to seek PAS, they are opening the door to liquidate this feeling. If a patient knows he or she can take PAS to resolve these worries in the end they will have a more peaceful transition into

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

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

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.

A POLST, which is a Physician Orders For Life-Sustaining Treatment, is starting to become common in Healthcare Community, but it’s not limited to there. However, there is not much of a push to offer it outside of the community. A POLST is not the same as a living will or a power of attorney, but is a program “are designed to elicit and honor the medical treatment goals of persons with advanced progressive illnesses or frailty by creating an immediately effective medical order.” (Wolf, Maag, & Gallant, 2014). If available a POLST is a very valuable tool since, “it creates standardization and consistency. Ideally, a POLST form should move with the patient wherever the patient goes-from his or her home, then to a hospital, to a skilled nursing

In addition, the legality of living wills is still being challenged in about 25 percent of all cases, decisions are made -– by family or physician – that are contrary to the patient’s wishes as stated in their living will (i.e.

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.