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3. Literature review of palliative care
3. Literature review of palliative care
3. Literature review of palliative care
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This paper will focus on the two different sides of adolescents and their choice concerning end of life care. The first section will be adolescent centered and will help to provide a backbone to reinforce the choices they legally should be able to make using their right to autonomy. The American Academy of Pediatrics and the Institute of Medicine did a very helpful study, that is pro adolescent choice that will be discussed in the first section of the paper. The second section will focus on Paternalism and the ethics behind the health care team making the ultimate decision that will benefit the patient. As well as information and studies in regard to an adolescent’s decision making process, and their tendency to be impulsive. Keywords: adolescents, end of life, healthcare, choice, autonomy, paternalism, impulsiveness, decision-making Adolescents and the Choice of End of Life End of Life Care involves choices such as hospice some instances, if that is what the patient chooses. Hospice involves that of palliative care, where health care professionals instead of treating the illness treat the patient they help to keep them comfortable and eliminate pain (Allender, Rector & Warner 2010). The choice of a patient’s end of life care is often considered after the diagnosis of a terminal illness, and the patient is able to decide how they would like to spend the rest of their days. Adolescence is characterized by a time of growing and finding ones self, which makes the debate about whether or not an adolescent should be able to make a decision about their own health care. In Favor of Adolescents’ Choice At what age should a person be able to make big decisions in life? We all start off having every choice made for us, that for the mo... ... middle of paper ... ... 37(8), 712-731. doi:10.1080/87565641.2012.718815 Quinn, G.P., Murphy, D., Knapp, C., Stearsman, D., Bradley-Klug, K. L., Sawczyn, K., & Clayman, M. (2011). Who decides? decision making and fertility preservation in teens with cancer: A review of the literature. J Adolesc Health, Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179606/ Tang, L. (2012). The patient’s anxiety before seeing a doctor and her/his hospital choice behavior in china. BMC Public Health, Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3536590/ 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).
The purpose of this article was to inform readers of the thoughts and feelings of patients, families, and physicians. This article informs others of what is really in the thoughts of people going through physician assisted suicide. The audience can be anyone from other physicians to patients and families or anyone who wants to read about this topic. This article can help explain why physician assisted suicide has more positive than negatives. It helps to explain the thought process and feelings of someone who had to really consider this as an option.
As we get older and delve into the real world, it is important to start thinking about end-of-life care and advance directives. Although it is something no one wants to imagine, there is an absolute necessity for living wills and a power of attorney. Learning about the Patient Self-Determination Act and the different legal basis in where you live is important because it will help people understand why advance care directives are so important. Although there are several barriers in implementing advance care directives, there are also several actions that healthcare professionals can take to overcome these obstacles. These are also important to know about, especially for someone going into the medical field.
The issue at hand is whether physician-assisted suicide should be legalized for patients who are terminally ill and/or enduring prolonged suffering. In this debate, the choice of terms is central. The most common term, euthanasia, comes from the Greek words meaning "good death." Sidney Hook calls it "voluntary euthanasia," and Daniel C. Maguire calls it "death by choice," but John Leo calls it "cozy little homicides." Eileen Doyle points out the dangers of a popular term, "quality-of-life." The choice of terms may serve to conceal, or to enhance, the basic fact that euthanasia ends a human life. Different authors choose different terms, depending on which side of the issue they are defending.
The word “euthanasia” comes from the Greek words “eu” meaning good or well and “thanatos” meaning death. Euthanasia means to take a deliberate action with the express intent of ending a life in order to relieve intractable suffering. Belgium has passed a law that allows euthanasia for terminally ill children experiencing “constant and unbearable suffering” who can show a “capacity of discernment”. This has sparked many debates about whether child euthanasia is moral and whether it should be legal or not. Although child euthanasia is a way for a child to escape “constant and unbearable” suffering or to avoid suffering through a terminal illness, child euthanasia should not be legal because children do not possess the mental capacity to make a request for such an irreversible decision, a child may choose to die because they fear that they are burdening others, and the requirements in place to request euthanasia may not be sufficient enough to protect against misuse.
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).
Hospice always patient and families the automaty to decide a choice of end of life care. It allows who prefer to end life in their homes, pain free, surrounded by family and loved ones: Hospice works to make this happen. The focus in on caring, not curing. Hospice utilizes an interdisciplinary team of healthcare professionals and trained volunteers that address symptom control, pain management, and emotional and spiritual support expressly tailored to the patient's needs and wishes. Hospice is not “giving up,” nor is it a form of euthanasia or physician assisted
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.
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.
Although minors are not fully educated or mature enough to make medical decisions for themselves, there are some minors who have been through treatment a lot that do understand their condition. In the article, “Right to Die”, the author James Deacon states that for a child to refuse treatment, they must have the maturity and intelligence to make an informed choice. But the most important is that the child must have the clarity of thought under the circumstances to understand the consequences of either being treated or refusing treatment (Deacon). The author is concluding that if the child is new to this situation and doesn’t know what is going on, then they shouldn’t be allowed to refuse treatment and the medical professionals have every right
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.
One of the many concerns is allowing incompetent individuals making this irreversible decision, which is why, “all have agreed that this end-of-life option should apply on to competent individual’s”(113). In addition, people opposed to this method argue that patients demanding this process are suffering from depression and not able to make decisions; yet, Rosenfled explains that practitioners most ensure that patients who consent to this medical intervention do it voluntarily, knowingly and
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...
Death is a universal truth. Hospice reduces the suffering associated with death. Hospice is considered the philosophy and model for quality, compassionate care to terminally ill patients. Patients accepted into a hospice program usually have a prognosis of less than six months to live (Potter, Perry, Stockert & Hall, 2017, p. 761). Hospice provides skilled medical care, pain management, emotional, and spiritual support tailored to the patient’s needs and wishes. The goal of hospice is to focus on the quality of life during the end of life. It gives patients a sense of dignity, provides patients and families with support, and it is cost effective. Today, seven out of ten Americans die from chronic disease. By 2020, the number of people living with a chronic illness will increase to 157 million (Hogan 2012). As the elderly population in the U.S. continues to increase, the importance of hospice will only continue to grow.
THOMAS, K. and LOBO, B., 2011. Advance care planning in end of life care. Oxford: Oxford University Press.