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Advanced health directive and legal and ethical principles
Ethical controversies in end of life
Ethical case study for end of life care
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End of life can be completely difficult to cope with, but is a part of everyday life. End of life pertains to the last days of a patient’s life, which means that end of life requires many important decisions such as medical treatment and knowing when to terminate life support. So planning end of life can be extremely difficult for the patient and their family members. They will have to make the decision on where the patient want to spend their last days, treatments they wish to have and not to mention their goals of care. This topic is truly important because not many individuals realize what comes with dealing with end of life care.
However, when it comes to medical treatments the patient must decide whether or not they would like to continue their current
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What is extremely important is following the doctor’s orders to make the patient as comfortable as possible.
Not to mention, if you have a patient that is on life support and the doctors are unable to help them any longer the family must decide what they are going to do. Therefore, terminating life support can be a difficult decision to make, especially when it’s your loved one. That is why it is important to have an advance directive or living will on file. This will enable the patient to take these difficult decisions off of their family members. It also will ensure that the doctors acknowledge the patient’s wishes.
As a matter of fact, according to research the percentage of advance directives being completed is up to 80%. Where as in the early 2000’s only a staggering 29% of patients had an advance directive. This number is extremely significant because it means that family and loved ones are beginning to understand the importance of having an end of life care plan. Not only that, they are laying a strong foundation for the medical professionals. This will let physicians and nurses know what life saving techniques they can and cannot use according to this
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. The book states that quality of life changes throughout one’s life and experiences.
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).
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 decision to end a life is a difficult one no matter the situation presented. It stirs a great deal of emotions when thinking about a loved one choosing to die in situations where they are terminally ill. Death is a scary thought for most people, but we need to remember that it is just a fact of life, no matter how morbid it sounds. There is some dignity in ending a life for a patient is who terminally ill and suffering, although it may be a tough decision, it can sometimes be the right one.
Patients are ultimately responsible for their own health and wellbeing and should be held responsible for the consequences of their decisions and actions. All people have the right to refuse treatment even where refusal may result in harm to themselves or in their own death and providers are legally bound to respect their decision. If patients cannot decide for themselves, but have previously decided to refuse treatment while still competent, their decision is legally binding. Where a patient's views are not known, the doctor has a responsibility to make a decision, but should consult other healthcare professionals and people close to the patient.
Hospice focuses on end of life care. When patients are facing terminal illness and have an expected life sentence of days to six months or less of life. Care can take place in different milieu including at home, hospice care center, hospital, and skilled nursing facility. Hospice provides patients and family the tool and resources of how to come to the acceptance of death. The goal of care is to help people who are dying have peace, comfort, and dignity. A team of health care providers and volunteers are responsible for providing care. A primary care doctor and a hospice doctor or medical director will patients care. The patient is allowed to decide who their primary doctor will be while receiving hospice care. It may be a primary care physician or a hospice physician. Nurses provide care at home by vising patient at home or in a hospital setting facility. Nurses are responsible for coordination of the hospice care team. Home health aides provide support for daily and routine care ( dressing, bathing, eating and etc). Spiritual counselors, Chaplains, priests, lay ministers or other spiritual counselors can provide spiritual care and guidance for the entire family. Social workers provide counseling and support. They can also provide referrals to other support systems. Pharmacists provide medication oversight and suggestions regarding the most effective
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.
Terminally ill patients deserve the right to have a dignified death. These patients should not be forced to suffer and be in agony their lasting days. The terminally ill should have this choice, because it is the only way to end their excruciating pain. These patients don’t have
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 end-of-life nurse’s primary objective is to provide comfort and compassion to patients and their families during an extremely difficult time. They must satisfy all “physical, psychological, social, cultural and spiritual needs” of the patient and their family. (Wu & Volker, 2012) The nurse involves their patient in care planning, as well as educating them about the options available. They must follow the wishes of the patient and their family, as provided in the patient’s advance directive if there is one available. It is i...
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 part of the circle of life and it's the end of your time on earth; the end of your time with your family and loved ones. Nobody wants to die, leaving their family and missing the good times your loved ones will have once you pass on. In the Mercury Reader, Elisabeth Kübler-Ross “On the Fear of Death” and Joan Didion “Afterlife” from The Year of Magical Thinking” both share common theses on death and grieving. Didion and Kübler-Ross both explain grieving and dealing with death. Steve Jobs commencement speech for Stanford’s graduation ceremony and through personal experience jumps further into death and how I feel about it. Your time is on earth is limited one day you will die and there are many ways of grieving at the death of a loved one. I believe that the fear of death and the death of a loved one will hold you back from living your own life and the fear of your own death is selfish.
THOMAS, K. and LOBO, B., 2011. Advance care planning in end of life care. Oxford: Oxford University Press.
In every death there is some kind of issue, but recently, ‘pulling the plug’ has become an even worse one. When a loved one dies we all deal with in it different ways, anything to cope with it, but when can we consider it as too far? In my personal opinion, the case of Jahi McMath has gone extremely too far. ‘She was pronounced brain dead on December 9th, 2013 by the coroners office after suffering from rare complications.’ (McCullough, Laurence. Ethicists criticize treatment of teen, Texas patient) Jahi has been placed on a ventilator, but she is a vegetable. Her heart is artificially beating and has also ‘had one tube inserted in her throat and another into her stomach to pump nutrition’ (McCullough, Laurence. Ethicists criticize treatment of teen, Texas patient). I understand that losing your child would be hard and some people just really can’t cope with it, but how can they just stand there and watch their ...
Current definitions of life and death have been categorized into two different cases: neurological and cardiorespiratory. Each category has a definite list of qualifications in order for death to be determined. Just the same, each category has contradictions and odd cases in which cardiorespiratory or neurological function are restored. 4 These contradictions leave room for opposition to the new definition of death. Many people and religious groups are not satisfied with the two categories of death. Scholars urge all to consider life as a social construct. We may not be able to determine death positively, but we can consider a patient’s quality of life, level of personhood, interaction with their external environment, and ability to maintain vital signs organically. These considerations may be a step toward the most modern definitions of life and death.