Dealing with end-of-life planning and problems is something we wish to never do but its occurrence is inevitable. Our human mortality causes us to live a life approaching death. Therefore, it is important to have a plan set incase one gets diagnosed with a life-threatening illness or if one will eventually become incapacitated. Being incapacitated means the person is no longer able to make rational medical decisions about his or her health due to a physical or mental change. (1) An example of a person becoming incapacitated is if he or she were to go into a vegetative state of develop early-onset Alzheimer’s’ disease. Many people have a will set in place that contains their desires of how to proceed with medical treatment. Through these wills, the person can indicate which facility they wish to be placed in in case they become incapacitated and cannot make the decision for themselves. There are search engines provided by the state government that allows the person to search a variety of facilities. The facilities include Home Health Agencies, Hospices, Companion services, and Nurse registries. (2) If there isn’t a will in place, then the state will need to take certain steps to determine what the patient would have wanted.
The following are the revised policy steps the state will need to take in the absence of a will. The first thing the state will need to do is try to locate any other advance directives. An advance directive is a written or oral statement about how one wants medical decisions made should he or she not be able to express his or her wish. (1) The types of advance directives are living wills, health care surrogate designations, and anatomical donations. If this individual has a health care surrogate designation, t...
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...owing assisted suicide. The only exception of allowed assisted suicide for an incapacitated individual, who is not terminally ill, is if he or she is in a permanent vegetative state. In this case, the patient’s relative will have to appear in front of a health council to prove why this is the best decision to be made and why their family member would choose to die if allowed to make the decision. Neurologists will need to examine the patient to see if the person is in fact in a permanent vegetative state. These will be the steps, procedures, and policies needed to be followed throughout my term as your Surgeon General. Any questions or specific cases will be addressed after reinforcing said policies.
Works Cited
1. http://www.floridahealthfinder.gov/reports-guides/advance-directives.aspx
2. http://www.floridahealthfinder.gov/facilitylocator/FacilitySearch.aspx
The controversial act known as the physician aid-in-dying (PAD) challenges us to question our ethical, religious, and cultural values or beliefs. Although it is tragic and perceived as morally inappropriate, suicide is sometimes the only answer. In certain cases this act is a way to end excruciating pain and suffering. The state of Oregon passed a law known as the Death with Dignity Act in 1994. PAD is defined as “a practice in which a physician provides a competent, terminally ill patient with a prescription for a lethal dose of medication, upon the patient's request, which the patient intends to use to end his or their own life” (Braddock, and Tonelli). PAD also raises the question, is it a constitutionally guaranteed right for people to have the power and the medicine to take their own life? PAD, if operating under careful supervision, is an alternative to patients who may have to endure physical, mental, and financial struggles. Doctor Peter Goodwin, a physician from Portland, Oregon campaigned for the Death with Dignity Act, which he called his greatest legacy. Goodwin became a terminally ill patient towards the end of his life. Doctor Goodwin was 83 years old when he took the very medicine that he campaigned so long for. Goodwin was diagnosed with a rare brain disorder, which he had been battling for 6 years prior to PAD.
While navigating the abundant and sometimes confusing legal language of advance directives can be time consuming, it would benefit every person to consider their end of life wishes and have some form of written statement available for their doctor and family to understand those wishes. Doing this in advance can prevent emotional anguish, suffering and expensive litigation. In the end, clearly and when possible, written, documentation of a medical directive, a living will, or a chosen health care power of attorney will lessen the burden for the medical professionals and family of a dying or incapacitated person.
Wiener, Lori, Elizabeth Ballard, Tara Brennan, Haven Battles, Pedro Martinez, and Maryland Pao. 2008. "How I wish to be remembered: the use of an advance care planning document in adolescent and young adult populations." Journal Of Palliative Medicine 11, no. 10: 1309-1313. MEDLINE with Full Text, EBSCOhost (accessed May 26, 2014).
Prior to discussing why Advanced Directives are so essential the definition of Advanced Directives is crucial. An Advanced Directive is made up of several legal components which ultimately online the patient’s wishes if one was to be incapacitated or unable to verbally make wishes know regarding healthcare. The understanding of what a living will and a durable power of attorney both need to be discussed before one is able to compare and contrast. A living will ensures that anyone reading this paper will understand how the patient wanted to continue their form of treatment. With a living will anyone ranging from patients to healthcare professions should be able to determine the specific actions the patients would want taken if they are unable to make said wishes known. A
Increasingly, people know from their own experience some painful dilemmas involving elderly or handicapped individuals who are in pain. While the achievements of modern medicine have been used to prolong and enhance life for many, they have also helped create an often dreaded context for dying. Costly technology may keep persons alive, but frequently these persons are cut off from meaningful relationships with others and exist with little or no hope for recovery. Many fearfully imagine a situation at the end of their lives where they or their trusted ones will have no say in decisions about their treatment.
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
Healthcare providers must make their treatment decisions based on many determining factors, one of which is insurance reimbursement. Providers always consider whether or not the organization will be paid by the patients and/or insurance companies when providing care. Another important factor which affects the healthcare provider’s ability to provide the appropriate care is whether or not the patient has been truthful, if they have had access to health, and are willing to take the necessary steps to maintain their health.
The first journal article is about advance care planning (ACP) in palliative care. This is of interest due to several clinical experiences and the realization that many families either ignore the patient’s request for end of life (EOL) care or who have no idea of how to plan for EOL care. By reading the research and understanding the methods used, this will allow for insight into how to implement palliative care into clinical practice across different sites. The authors of this original research are Jeanine Blackford PhD, RN, senior lecturer at La Trobe University in Australia, and Annette Street PhD, associate dean of research and professor of cancer and palliative care studies. According to Blackford & Street (2011), this research is important as there are many countries that “report a low percentage of people who have completed an advance care plan” (p. 2022), and ACP is needed upon admission to facilities that offer palliative care. In addition, the purpose of the study is to try and obtain guidance to integrate an ACP model into routine clinical practice in the community. The research question chosen for the analysis of this article is: Is it feasible to implement ACP into routine practice and documentation at multi-site locations in...
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
The Public Health Imperative measures the quality of life of an individual during times of severe chronic illness. This health imperative is characterized by: the potential to prevent suffering caused by the illness, major impact, and high burden. In the recent past is has become evident that care for older people, who have potential to become terminally ill, must be focused on. The types of patients may also lose the capability to make some of their most important decisions which include actions made by health professionals that are related to their end of life situation. Luckily actions were made to identify certain priorities pertaining to the public health and end of life issues. These priorities were established by the National Association of Chronic Disease Directors and the Healthy Aging Program at the Centers for Disease Control and Prevention. These end of life health priorities which address short-term, medium-term and long-term needs are also called advanced care planning. It can be concluded that communication between professionals and among families about the patient can enhance the effectiveness of advanced care planning.
One of the greatest dangers facing chronic and terminally ill patients is the grey area regarding PAS. In the Netherlands, there are strict criteria for the practice of PAS. Despite such stringencies, the Council on Ethical and Judicial Affairs (1992) found 28% of the PAS cases in the Netherlands did not meet the criteria. The evidence suggests some of the patient’s lives may have ended prematurely or involuntarily. This problem can be addressed via advance directives. These directives would be written by competent individuals explaining their decision to be aided in dying when they are no longer capable of making medical decisions. These interpretations are largely defined by ones morals, understanding of ethics, individual attitudes, religious and cultural values.
Take for instance the case of Matthew Donnelly. Mr. Donnelly’s body was riddled with skin cancer from years of working with X-rays. Mr. Donnelly had been in a declining state of health for years and he wanted to be alleviated of this pain. He had lost his nose, his left hand, two fingers on his right hand and part of his jaw. Since his state had no rules for assist...
THOMAS, K. and LOBO, B., 2011. Advance care planning in end of life care. Oxford: Oxford University Press.
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
Having six months or less to live or having an illness in which patients finds themselves faced with a decision on how they are going to spend those remaining days are issues that arise in the healthcare setting. For some it is making lasting memories with their loved ones, while for others it is trying to hasten their own death. Dilemmas have been encountered by hospice workers concerning the ethical and unethical issues of patients they are caring for when choosing alternatives rather than palliative. Palliative care is specialized medical care for people with serious illnesses. It is focused on providing patients with relief from the symptoms of pain and stress of their illness while providing comfort measures. The goal is to improve quality of life for both the patient and their family Making the Case (2014) Retrieved from http:www.capc.org. Palliative care is provided in a hospice setting or in one’s own home during his or her dying days. In a study of end-of-life care done in the United States it was found that patients in hospitals often do not have their needs for pain management or treatments provided to their full potential (Connor, 2007-2008, P.93). When a patient is suffering or they just don’t want to deal with waiting to die, they choose to take matters into their own hands by either Voluntarily Stop Eating and Drinking (VSED) or Patient Assisted Suicide (PAS). This paper will explain the ethical and unethical dilemmas that are presented in a hospice environment when dealing with VSED and PAS.