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Essays on advance care directives
Essays on advance care directives
Essays on advance care directives
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The external reading talked about what a person can do about their decisions regarding their health and medical treatments. This is known as advance directive planning. This I done through living will, power of attorney and health care proxy. There were three characteristics that the article talks about that influences an individual’s decision making in this process. These are religious beliefs and advance directives, changes as we age, and Erickson’s Theory. The author incorporated Erikson’s theory by focusing on the final stage which was “integrity vs. despair”. According to Erickson’s theory people go through eight different life stages. The individual “faces a crises and progresses through to the next stage whether or not they resolved
On the topic of Atul Gawande’s novel Being Mortal: Medicine and What Matters in the End, an ongoing issue has brought into question what we should do with the elderly and ill that are in need of care. On the one hand, some argue that they should be put in nursing homes and seek treatment for their problems because they can no longer take care of themselves. From this perspective, the elderly have a greater chance of getting injured if they are not taken care of properly, thus are seen as unfit to live on their own. On the other hand, however, others argue that the elderly should be allowed to live on their own as long as they maintain a healthy lifestyle. Atul Gawande, one of this view’s main proponents, urges us to realize that no one is immortal
The ethical principle of nonmaleficence demands to first do no harm and in this case protect the patient from harm since she cannot protect. Nurses must be aware in situations such as this, that they are expected to advocate for patients in a right and reasonable way. The dilemma with nonmaleficence is that Mrs. Boswell has no chance of recovery because of her increasing debilitating mental incapability and the obvious harm that outweighs the intended benefits. If the decision were to continue treatment, suffering of the patient and family would be evident. Autonomy is the right to making own decisions and freedom to choose a plan of action. When making decisions regarding treatment of another person, it is important to respect the expressed wishes of the individual. John says that his mother would want to live as long as she could, but questions arise related to her quality of life and perception of prolonged suffering by prolonging the dying process. In BOOK states that quality of life changes throughout one’s life ...
Due to the growing issue dealing with the aging baby boomers generation, gerontology has been brought into immediate attention in the health care system. We are still learning and discovering about the anonymities behind the aging processes. Aging and death is a normal stage of life, even though there is an increase in technology and knowledge that would lengthen your existence, bringing the body back to youth is not possible. As one ages it is very common for one to go through physical, psychological and mental degeneration of the body. In the gerontological setting, it is important for nurses to commit to caring and providing a good quality of life. This is done by providing a dignified death instead of simply sustaining life. In order to make this happen it is important to incorporate Jean Watson’s caritas processes into the care plan. By providing good person to person care a nurse can improve the quality of life of patients and their family members. This paper will focus on the use of caritas process number 9 in the gerontological setting to develop a healing relationship with my client, use of professional knowledge needed to assist my client in his/her needs, a nursing action that helped my client’s needs and the difference the care made to my clients healing. In the gerontological setting, “spirituality must be considered a significant factor in understanding healthy aging” (Touhy, Jett, Boscart, & McCleary, october 2011, p. 98). Gerontological nurses have to put spirituality of an older adult in priority, because as you age spirituality is very important to them and it is source of hope and helps them in adaptation of their illness. Findings of a Canadian community health sur...
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.
The individual will need to be encouraged to make decisions about the care they receive and the type of life they want to live and also ensure that their families are part of the decision making process.
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.
When it comes to a bad diagnosis it is often difficult for doctors to tell their patients this devastating news. The doctor will likely hold back from telling the patient the whole truth about their health because they believe the patient will become depressed. However, Schwartz argues that telling the patient the whole truth about their illness will cause depression and anxiety, but rather telling the patient the whole truth will empower and motivate the patient to make the most of their days. Many doctors will often also prescribe or offer treatment that will likely not help their health, but the doctors do so to make patients feel as though their may be a solution to the problem as they are unaware to the limited number of days they may have left. In comparison, people who are aware there is no cure to their diagnosis and many choose to live their last days not in the hospital or pain free from medications without a treatment holding them back. They can choose to live their last days with their family and will have more time and awareness to handle a will. Schwartz argues the importance of telling patients the truth about their diagnosis and communicating the person’s likely amount of time left as it will affect how the patient chooses to live their limited
This freedom of choice, Gawande states, ultimately places a burden on either the doctor or the patient as the patient ultimately choose a course of treatment that is ultimately detrimental as in the case of Lazaroff, a patient with only a few weeks to live, but rather insist on “the day he would go back to work.” Despite the terrible risks and the limited potential benefits the neurosurgeon described, Lazaroff continued to opt to surgery and eventually died painfully as a result of surgery. Gawande suggests that Lazaroff “chose badly because his choice ran against his deepest interests,” which was to live despite his briefing remaining time, ultimately distorting his judgement into choosing a course of treatment that ultimately ended his life in a much more painful manner. Another case of patient decisions that Gawande discusses is Mr. Howe, who aggressively refused to be put on a breathing machine, neglecting the fact that “with antibiotics and some high-tech support...he would recover fully.” As Gawande and K awaited for Mrs. Howe’s decision to save her husband’s life, Mrs. Howe emotionally breaks down
Desjarlais, R., & Throop, C. J. (2011). Phenomenological approaches in anthropology. Annual Review of Anthropology, 40, 87-102. doi: 10.1146/annurev-anthro-092010-153345.
Lifespan development is essential, as it is the changes that happen to us throughout a person’s lifespan. Our development occurs at ages stages where we develop from infancy till death. This essay will contain my life story to display the domains in 5 age stages in my lifespan development. The domains I will be exploring is in this essay is physical, emotional, cognitive, social, cultural and moral domain. The influence of biological and environmental play a significant role in my development. Development is influenced by nature or nurture and its affect will occur throughout lifespan. The changes that occur during development have stage. Each theorists has stages of development where they display the changes. This essay will explore my development that will support theorist such as Erikson, Vygotsky, Berk, Piaget and other theorist. The age stages of prenatal will display physical and emotional domain, Infancy (0-2) will portray social and emotional domain, young children (2-6) will show cognitive and social domain, middle childhood (6-12) will display socio-cultural and moral domain and adolescence will portray nature vs. nurture and cultural domain. Development is crucial for a healthy wellbeing. As a physiotherapist it is significant to understand development in age stages, as it will aid knowing how young children will react compared to an adolescence who is more development mentally, emotionally, physically, socially and culturally.
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 principle of autonomy states, that an individual’s decision must be respected in all cases, also an individual can act freely in accordance to their plan. For example, in a case where a patient and family demands to continue medical or surgical care and a physician want the patient to stop further treatment. In this case the patient’s choice will matter the most. According to the principle of autonomy it will be the patients and family choice whether to continue or discontinue treatment. The principle of beneficence which states, “one must promote good” comes into play in this case. In accordance to beneficence the patient will not benefit from the physicians responses personally. He/she will not benefit from harming her body with more surgeries. The patient will be going against the principle non-maleficence, which states that “one must cause no harm to an individual” by causing harm to herself. In this case the physician is justified in his/her actions by discontinuing medical or surgical care to the patient because it will not it her. These principles are what healthcare provider use to help and guide patients with the ...
All development is contextual meaning that development can occur in places like churches, communities, and businesses. Development can also occur within family members, group of friends or with just everyday people. Development can be influenced by three major factors: normative age-graded and normative history-graded influences and non-normative life events. These influences can have either a big or a small impact on both the individual and the individual’s environment.
Erik Erikson developed the eight stages of life theory. Erikson’s theory focuses on the development from birth to death, social context, and interpersonal relations during each stage of life (McAdams, 2009). In the same manner, each stage of life is comprehendible in three levels, such as the body, ego, and family and culture. The eight stages of life are infancy (trust vs. mistrust), early childhood (autonomy vs. shame and doubt), childhood (initiative vs. guilt), childhood (industry vs. inferiority), adolescence and young adulthood (identity vs. role confusion), young adulthood (intimacy vs. isolation), mature adulthood (generativity vs. stagnation (or self-absorption)), and old age (ego integrity vs. despair).
We as health care professionals need to work side by side with the families to provide the best care and decisions that are right by our patients. We have to be mindful of the cause and effect our course of treatment depicts for our patients. No individual wants to live in pain or misery, we all want to be healthy and happy and are willing to go great lengths to achieve this goal. Death is the final stage of life, but as we live and get older we start to prepare for death as to not fear death but accept it. Health care professionals may benefit from the opportunity to acknowledge, normalize and integrate death and dying into the continuum of life, both for themselves as well as their patients. (Sinclair, 2011) With advancements in technology and medicine we are living longer and fuller lives, and given time quality of life will only continue to improve.