Advance Care Directives Research Paper

The increased use of advanced directives, such as do-not-resuscitate orders, has made discussions on end-of-life care much easier for patients and professionals alike.

This paper concerns the ethical basis for advance directives, or “Living Wills”; the value of these advance directives to the patients, their families; and the authorities that these advance directives give the above mentioned interested parties.

There are two types of advance directives: a Living Will and the Durable Power of Attorney for Health Care. A Living Will requires a witness or be notarized and consists of a directive that instruct the acting physicians to not utilize medical interventions in an instance that the patient is unable to make their immediate medical decision. The Living Will is the oldest form of advanced directives, requires a patient be terminally ill and it states that its interpretation is only to be assumed by the patient and their physician, there is never to be any family influence or interpretation of a Living Will. Durable Power of Attorney for Health Care is also witnessed or notarized and identifies an ‘agent’ to make health care decisions if the signer is unable to make their own decision. An agent is an individual that the patient chooses with great care, due to the amount of power/authority that is assumed to making such decisions. The Durable Power of Attorney does not require that a patient be terminally ill and is interpreted by the identified ‘agent’. There have also been known to be hybrid documents that combine elements of a Living Will and Durable Power of Attorney for Health Care that acts as an Advanced Directive. (Advanced Directives.,

When you are able, you should put thought into the physical process you will go through. All of us love you and want to make sure that when the time comes, we know and can follow your wishes regarding the care you wish to receive. Having your decisions thoroughly and clearly stated in an advance directive will make this possible. (Berger, 2014, p. 590). Your advance directive document may contain a living will, a signed consent for Do Not Resuscitate (DNR), and information identifying your healthcare proxy. Understanding these things now, will help you make clear choices. A living will clarifies what care, or lack of care, you wish to have (Berger, 2014, p. 590). This is helpful for reference if you are ever unconscious or in any way incapable

Figure 1 displays each state within the United States and which form of advanced directive they have adopted into their individual state’s laws. Utah is one of twenty-eight states which have implemented an advanced health care directive with both a living will and a durable power of attorney for health care. In the state of Utah advanced health care directive is defined as “a designation of an agent to make health care decisions for an adult when the adult cannot make or communicate health care decisions; or an expression of preferences about health care decisions” (le.utah.gov). Agent is defined as “a person designated in an advance health care directive to make health care decisions for the declarant (le.utah.gov).” An individual has the right to not appoint and agent on Utah advanced health care directive forms as well (le.utah.gov).

Medical technology today has come a long way. Numerous life prolonging procedures are available that can extend a person’s life where once they would have expired. Kidney dialysis, chemotherapy, cardiopulmonary resuscitation (CPR), feeding tubes, intravenous hydration, and ventilators are but a few of these means for extending one’s life. The choice between quantity versus quality of life is complex, and not one that should be left up to chance. In 1990, Congress passed the Patient Self-Determination Act (PSDA).

Every person except one did not know what an advanced directive states. The only interview that knew what I was asking was because they had just lost a loved one and their family was going through the situation. There were five children in the family. They had two children as execrator of the will and one child as a healthcare power of attorney. Before the death, the client states to have a full code with no artificial nutrient or ventilation. They only sought out partial interventions which made their status a code C. During this time the patient coded, and the wishes the client states stood strong. Therefore, it is so important to have an advance directive on file or with the next of kin. You never know when this time will happen but you can be proactive, and be prepared for any situation to

The Advance Directives form is somewhat different but its purpose is the same: to let an individual make end of life decisions. It is a longer form, with more involved questions.

Within the past ten years, multiple studies have been conducted regarding the completion rates of advance directives. Topics discussed include structure, evolution, benefits and challenges of advance directives (Perkins, 2007; Castillo, Hooper, Sabatino, Weithermon & Sudore, 2011; Cohen, MCannon, Edgman-Levitan & Kormos, 2010; Halpern et. all, 2013; Johnson, Zhao, Newby & Granger, 2012;Later & King, 2007; Mickelsen, Bernstein, Marshal & Miles, 2013; Yoo, Nakagawa & Kim, 2013; Waite et. all, 2013; Watson, 2010). Through initial research the same articles also provided possible solutions and recommendations that could be used to improve advance directives education procedures. However, the data did not provide a guideline that instructed how to conduct patient education procedures for advance directives. Therefore, the discovered data will be used to develop a possible guideline.

An advanced directive is a legal document in which a person can specify what measures should be taken, when considering their medical condition, in the event that they are incapable of making decisions for themselves.  Advanced directives are more often used by patients who have mental and terminal illnesses.  When given a scenario in which a dementia patient like David signed an advanced directive, there are many things to be considered before deciding whether or not to treat his pneumonia:  what is best for his health, what is considered ethical for the physician to do, and what effects would the physician’s decision have on the hospital. David should be treated for his pneumonia because, when considering the medical aspect of this case, it

This film explains the legal role of advance directives in end of life issues. An advance directive is “a written document directing how medical decisions are to be made in the future when the patient lacks decisional capacity and is unable to decide and choose” (Hanlon, End of Life Issues, Slide 28, Bullet 1). All three of the cases demonstrate the importance in filling out some form of directive. When there is nothing to go off of, it makes decisions extremely tough for families and medical providers. Having legal documentation of patient wishes helps understand what treatments they would or would not consent to. In cases like

With an increasing aging population and growing numbers of individuals with chronic conditions, it is important for individuals to prepare for end-of-life care. An Advance Directive is a defined as a “legal document that provides data to critical care staff about patients’ wishes, especially when critical illness decreases decision-making ability” (McAdam, Stotts, Padilla, and Puntillo, 2005). An Advance Directive also allows for better communication between the patient and doctor, and preserves the autonomy of patients. It may also alleviate one’s family from any possible burden of uncertainty of one’s wishes. It provides guidance, which may avert arguments with family members concerning treatment choices (Cedars Sinai, 2015). The Patient

Another type of advance directive is a Durable Power of Attorney for Health Care. This is an individual appointed by the patient to represent their wishes when they are unable to do so on their own (Mahon, 2011). The type of advance directive is less important than the purpose that it is set to achieve. The purpose is to allow patient to have a say in the care they are provided at a time when they are able (Mahon, 2011). It is important to ensure an advance directive in order preserve one’s autonomy and participate in future care decisions. This paper will explore advance directives within the context of federal and state laws, legal and ethical principles, and implication for the registered

A person’s life can end at any age. They can depart quickly or slowly. End of life care, also known as palliative care, is the care of patients that are not only in their final hours or days but the patients with a terminal illness that has become incurable. End of life care takes into mind what the patient desires so it is recommended that they consider an advanced care plan also known as an advance directive and living will. These documents allow the patient to formulate decisions on the future of their care if, at any point, they cannot vocally express themselves.

Advance Directives are our wishes when we are at end of life stages of life that give specific direction of how, who, and when to treat us in our final days and hours. We can have documents drawn up to say what we want in the event we are in a state where we cannot voice our wishes aloud. These documents have legal and ethical basis, and they should be followed unless the legally or ethically unable to do so.