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14 rights of patients
Advanced health directive and legal and ethical principles
14 rights of patients
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DNR: Whose Right to Choose?
Do not resuscitate (DNR) is an order written by a doctor or written in an Advance Directive initiated by a patient. The self-determination act of 1990 established the right of a patient to in certain situations where they may be unable to make crucial medical decisions because of incapacitation(Geppert, 2010). Orders given by the patient instruct medical personnel not to perform life saving measures such as cardiopulmonary resuscitation. A DNR order may also be specific to a medical facility depending on state law a patient may be able to choose what type of DNR order they would like to have. Many patients have these orders decided well before the need for them, due to the fact that the patient must be of sound mind to make these decisions. ("Comfort care," 1995-2013)
The reasoning behind this act is due to the many medical advances made in life saving treatments. With new cardiopulmonary techniques a person may continue to have their heart and lungs kept functioning independently from other body functions or conditions. DNR orders now allow a patient to make conscientious decision about what they would want done in regards to life saving measures. Various life saving measures may prolong the inevitable but not improve the patients’ health status or achieve their same quality of life as they had before. ("DNR," “n.d”)
Many people do not like to talk about these issues or feel they are too young to worry about things such as Advance Directives. These orders should be set up and made clear by patients before they are terminally ill or faced with emergency situations where they would be incapable of making these decisions on their own. Under circumstances where patients do not have a DNR order in pla...
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...tate (DNR)order. (“n.d”). Retrieved from http://www.surgeryencyclopedia.com
Do not resuscitate orders and comfort care. (1995-2013). Retrieved from http://my.clevelandclinic.org
Do not resusitate orders. (1998). Retrieved from http://depts.washington.edu/bioethx/topics/dnr.html
Geppert, C. (2010). Saving life or respecting patient autonomy: The ethical dilemma of DNR orders in patients who attempt suicide. The Internet Journal of Law, Healthcare and Ethics, 7(1). Retrieved from http://ispub.com
Legal guide to do not resuscitate (DNR) orders. (2013). Retrieved from www.mhlac.org/Docs/legal_guide_dnr
Taylor, C. R., Lillis, C., LeMone, P., & Lynn, P. (2011). Values, ethics, and advocay. In Fundamentals of nursing : The art of science of nursing care (7th ed., pp. 84-107). Philadelphia, PA Baltimore, MA New York, NY: Wolters kluwer Lipincott Williams and Wilkins.
Although nursing is universally practiced, not all nurses values and morals are the same. Nurses and nursing students are usually put in situations where they must operate within an ethical structure which is either unfamiliar to their cultural criterion or those of the patients for whom they are taking care of. The most prominent values and morals of nurses are based on human dignity and benevolence. Human dignity is the main component that branches off into other values under caring for health and well-being. Trust, integrity, autonomy, and privacy are one of the many sub-values that fall under human dignity. It is important for the nurses to respect and understand the culture and beliefs of the patient without being judgmental or confrontational. The wellbeing of the patient is priority and so the nurses must focus on gaining the patients trust first by tending to their needs and exhibiting
There are many convincing and compelling arguments for and against Physician Assisted Suicide. There are numerous different aspects of this issue, including religious, legal and ethical issues. However, for the purpose of this paper, I will examine the ethical concerns of both sides. There are strong pro and con arguments regarding this, and I will make a case for both. It is definitely an issue that has been debated for years and will continue to be debated in years to come.
...o get a do not resuscitate order. That is an order that the families may sign so the hospital does not have to give effort to bring a person back to life anymore once they have stopped breathing.
There are many legal and ethical issues when discussing the topic of physician-assisted suicide (PAS). The legal issues are those regarding numerous court cases over the past few decades, the debate over how the 14th Amendment of the United States Constitution comes into play, and the legalization vs. illegalization of this practice. The 14th Amendment states, “nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws” (U.S. Const. amend. XIV, §1). PAS in the past has been upheld as illegal due to the Equal Protection Clause of the 14th amendment of the constitution, but in recent years this same 14th amendment is also part of the reasoning for legalizing PAS, “nor shall any State deprive any person of…liberty” (U.S. Const. amend. XIV, §1). The ethical issues surrounding this topic include a patient’s autonomy and dignity and if PAS should be legalized everywhere. This paper is an analysis of the PAS debate and explores these different issues using a specific case that went to the supreme courts called Washington et al. v. Glucksberg et al.
In this context, new emphasis is being placed on the rights of patients. Recent federal legislation, for example, requires all health care facilities receiving Medicare or Medicaid monies to inform patients of their right to make medical treatment decisions. This includes the right to specify "advance directives," [1] which state what patients wish to be done in case they are no longer able to communicate adequately.
understood DNR is in place? Or do we continue to treat only the symptoms of
In the medical field, there has always been the question raised, “What is ethical?” There is a growing conflict between two important principles: autonomy and death being considered a medical treatment. Physician assisted suicide is defined as help from a medical professional,
Thompson, I. E., Melia, K. M., & Boyd, K. M. (2006). Nursing Ethics: Churchill Livingstone Elsevier.
The right to assisted suicide is a significant topic that concerns people all over the United States. The debates go back and forth about whether a dying patient has the right to die with the assistance of a physician. Some are against it because of religious and moral reasons. Others are for it because of their compassion and respect for the dying. Physicians are also divided on the issue. They differ where they place the line that separates relief from dying--and killing. For many the main concern with assisted suicide lies with the competence of the terminally ill. Many terminally ill patients who are in the final stages of their lives have requested doctors to aid them in exercising active euthanasia. It is sad to realize that these people are in great agony and that to them the only hope of bringing that agony to a halt is through assisted suicide.When people see the word euthanasia, they see the meaning of the word in two different lights. Euthanasia for some carries a negative connotation; it is the same as murder. For others, however, euthanasia is the act of putting someone to death painlessly, or allowing a person suffering from an incurable and painful disease or condition to die by withholding extreme medical measures. But after studying both sides of the issue, a compassionate individual must conclude that competent terminal patients should be given the right to assisted suicide in order to end their suffering, reduce the damaging financial effects of hospital care on their families, and preserve the individual right of people to determine their own fate.
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.
When a patient is given PAS as an option it is ultimately their decision. However, Professor Raphael Cohen- Almagor of Hull University, said: “The decision as to which life is no longer ‘worth living’ is not in the hands of the patient but in the hands of the doctor.”(SPUC) Moreover, in Belgium, where euthanasia is legal, in 2013 the deaths of 1.7 people in every 100 people were hastened without the explicit request of the patient. National Right to Live News says, “vulnerable people feel pressured to choose death” and “saying to elderly, vulnerable people: ‘would you like us to help you die now?’ immediately makes them feel that their life has no worth.” In addition, some people feel vulnerable and obligated to continue with PAS. Daniel Callahan, a bioethicist says, “A lot of seriously ill people already feel they’re a burden because they’re costing their families money.”(Humphry) It is often said the decision is the patient’s, but it’s difficult to deny that often times they’re persuaded in some
The following are guidelines on things nurses can and cannot do. Nurses can provide care and comfort to the patient and family through all stages of the dying process, explain current law, be present during the patient’s self-administration of the medication, be involved in policy development, explore reasons for the request to name a few (Getter, 2013). Nurse cannot inject or administer the life-ending medication, subject peers, patients, and families to unwarranted or judgmental comments or actions, or abandon/refuse to provide comfort and safety measures to the patient (Getter, 2013). As with any licensure, that individual is responsible for following actions within their scope of practice. It is up to them to know their policies at an institutional and legal
Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics & issues in contemporary nursing (4th ed.). Stephan Helbra.
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 American Nurses Association created guidelines for the profession including, a set clear rules to be followed by individuals within the profession, Code of Ethics for Nurses. Written in 1893, by Lystra Gretter, and adopted by the ANA in 1926, The Code of Ethics for Nurses details the role metaethics, normative ethics, and applied ethics have within the field (ANA, 2015). Moral obligation for an individual differs within professions than it does within an individual’s personal life, so the code of ethics was written to establish rules within the profession. The moral obligation to provide quality care include the fundamental principles of respect for persons, integrity, autonomy, advocacy, accountability, beneficence, and non-maleficence. The document itself contains nine provisions with subtext, all of which cannot be addressed within this paper however, core principals related to the ethical responsibilities nurses have will be