Advanced Directives

It is extremely important that every patient has the opportunity to control the care they wish to receive in case of medical emergencies. These wishes may be addressed through legal documentation, known as advanced directives. Through the use of advanced directives patients can appoint a healthcare proxy, express their living will, and make decisions about hospice and palliative care. Advanced directives allow patients to make decisions that may be hard for their families, and their providers to make during this difficult time. “A living will spells out what types of medical treatment a person wants at the end of life if he’s unable to speak for himself ("Power of Attorney, Living Will, and Advance Directive - AARP").” When patients become

Life-Sustaining Treatments, also known as life-prolonging treatment or life support, help keep a patient alive when their necessary body functions begin to fail ("End-of-Life Decisions - CaringInfo"). This is a highly controversial advanced directive because it challenges, ethical and religious beliefs. If the treatment will provide temporary relief until the patient is able to carry out normal bodily functions, then they may consider these treatments, however if they are prolonging the inevitable shut down of all body systems they may not wish to prolong end of life treatment. Artificial nutrition and hydration is when the patient is unable to consume food on their own so a feeding tube is inserted into the stomach, intestines or veins, in order to provide nutrition to the patient ("End-of-Life Decisions - CaringInfo"). According to state law, a person can refuse artificial nutrition if it is stated clearly in the patients advanced directives. Cardiopulmonary Resuscitation (CPR) is a series of procedures that can restore breathing in a state of medical emergency. These procedures function in place of the heart and lungs until the can function on their own again. Ethical issues arise when the doctors believe that the patient will never regain function of the heart and lungs. Some people believe that if there is no hope that the patient will

Most require two or more witnesses and a notary, to assure that the patient is not forced into consenting to treatment they would not otherwise want. Witnesses generally do not include family members, or the person that the patient appoints as their healthcare proxy, because they may be beneficiaries of the patients estate. In some states, the patient’s doctors or healthcare providers cannot be used as witnesses. The patient does not need to share the content of the documentation with their witnesses. Patients should look into their state laws regarding advanced directive to ensure that the documentation meets the legal requirements ("End-of-Life Decisions - CaringInfo"). The Patient Self-Determination Act (PSDA) is the federal law regarding end of life care. PSDA requires facilities to let the patient know their policies and procedures, however it does not say that the facility has to accept a patients advanced directives, or that patients must have advanced directives. PSDA is meant to educate patients, and facilities and protect their rights ("End-of-Life Decisions -