Ethics in EOL Decisions
Finding Common Ground in EOL Care Decisions
Churchill (2014) presents to readers a case study to highlight some of the ethical and moral issues that will occur during end-of-life (EOL) decisions. The case study is not a factual event, but represents the mean severity and complexity of the EOL struggles experienced by the typical stakeholders. In this example, the treating physician has unsuccessfully tried to convince the adult daughter that her father will never recover from a coma and would benefit the most by palliative care, while the daughter refused to give up on the hope that her father would recover. Churchill (2014) spent time with clinicians and family member to try and understand their perspectives, thereby fulfilling his duties as a clinical ethics consultant. He discovers the patient has a living will and durable power of attorney, which prevented the use life-sustaining interventions in circumstances just like this; however, the patient was suffering from progressed Alzheimer's when the forms were signed, thereby limiting the validity of the documents. The surrogate named in the power of attorney likewise could no longer fulfill their role. A compromise was eventually reached and the patient received a percutaneous feeding tube and was transferred to a long-term acute care facility.
The message Churchill (2014) was trying to communicate is that EOL decisions typically involve multiple narratives. In the example he presents, individual narratives are provided by the daughter, the clinicians responsible for the care of the patient, the living will/durable power of attorney, and from Churchill himself as an experienced ethics consultant. When the goal is providing the best patient outcome from the perspective of the patient, Churchill (2014) recommends avoiding the trap of believing ethics consultants will know what is best for the patient and family members, both clinically and ethically. Instead,...
Advanced Directive The 1991 the Patient Self-Determination Act (PSDA) was designed to give patients and their families greater autonomy over making decisions in regards to end-of-life care and minimizing the extension life beyond what would be considered a 'quality' level. It has been said that "advanced care planning increases the quality of life of dying patients, improves the experience of family members and decreases health care costs" for patients of a
Advanced directive may be one of the most important and underutilized tools in estate planning and health planning. This is partially due to the stigma that people have about advanced directives, as if, by planning how to deal with health issues, they are somehow going to cause health problems. However, the reality is that most people will encounter at least one medical emergency during their lifetime. In the event that
However, it does mean that some things will be different from the normal line of treatment. ("Advance Medical Directives.," n. d.); (Feldman, Mitchell D; Christensen, John F. (2007) The fact that resuscitation of a patient through CPR will not add significantly to the quantity and quality of life is an indication that death may not be very far off and that medicine does not have the power to turn around
advance directives. The writer explores what they are and possible solution to reduce problems with them. There were three sources used to complete this paper. The past few decades have seen an increase in law suits revolving around the final medical wishes of those who fall ill. Media coverage has provided the nation with front row coverage when it comes to people in comas, vegetative states, and no hope of
For example, Wissow and colleagues (2004) collected gender, age, ethnicity, and levels of clinic/ED use. This information may provide valuable insight into who is most likely to create an advanced directive in response to the intervention. The time frame for the study was not mentioned or how long after the intervention the survey instrument would be presented to intervention participants. This could be relevant because some individuals exposed to
The DPAHC permits a person to name a successor to their proxy in the event that the proxy dies or otherwise not capable to assist in making choices at the time of need. It also permits a person to ascertain other constraint for boundaries of power. In most states it would also be legal to unite the two documents if a person wanted to (Cranston, n.d.). Discussions with relatives, legal
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