Making Sense of Advance Directives

Making Sense of Advance Directives PDF Author: N.M. King
Publisher: Springer Science & Business Media
ISBN: 9401133808
Category : Philosophy
Languages : en
Pages : 242

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Book Description
The first time I read the medical consent and authorization. it had registered in my mind simply as a legal document. Now I began to understand what it meant. It was a letter of ultimate love and trust. (Schucking. 1985. p. 268) Ever since Karen Ann Quinlan slipped into permanent unconsciousness in 1975 and her father agonized publicly over whether she should remain indefinitely on a respirator (In re Quinlan, 1976), the desires of patients, their families, and their friends to limit the application of apparently limitless medical technology have been a pressing concern for ethics, law, and public policy. Ms. Quinlan's case contained nearly all the elements of the problems we still face: vague, general, but sincere prior oral statements suggesting that she would not want continued treatment; a family attempting to do what they saw as best for her; and physicians uncertain whether to use medical judgment alone (and if so, what the "right" medical decision was), to preserve her life at all costs, or to honor the family's interpretation of their daughter's choice. Most ironically, once she was removed from her respirator, she did not die. Karen Quinlan - like dozens of other names made famous by court decisions, newspaper stories, and television evening news - has come to symbolize a tangled knot of issues surrounding the end of life and who controls it.

Making Sense of Advance Directives

Making Sense of Advance Directives PDF Author: Nancy M.P. King
Publisher: Georgetown University Press
ISBN: 9781589018600
Category : Medical
Languages : en
Pages : 308

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Book Description
Advance directives—such as living wills and health care proxies—are documents intended to declare and preserve the health care choices of patients if they become unable to make their own decisions. This book provides a comprehensive overview of advance directives and clear, practical directions for writing and interpreting them. Nancy M.P. King provides a legal, philosophical, and historical analysis of the moral and legal force of advance directives. She explains the types and models of advance directives currently in use and offers guidelines for individuals seeking to write, read, and use directives to promote individuals' health care choices within the laws of their own states. King emphasizes that advance directives are not orders given by patients to their doctors; instead, they are documents that invite conversation between doctors and patients about health care decisions of great importance. The purpose of advance directives is to support patients' health care choices, and the book promotes a thoughtful use of advance directives that is best calculated to achieve that purpose, whatever form individual advance directives may take. This new edition has been updated to reflect the many changes in advance directive statutes since 1991, including expanded discussions of health care proxy statutes, the impact of the Patient Self-Determination Act and the Supreme Court's Cruzan decision. King also has extended her analysis of the implications for advance directives of managed care, resource allocation, resource scarcity, and the debate over futile treatment at the end of life. Making Sense of Advance Directives is a valuable handbook for patients, health care providers and administrators, patient counselors, lawyers, policymakers, and any individual interested in advance directives.

Making Sense of Advance Directives

Making Sense of Advance Directives PDF Author: N.M. King
Publisher: Springer Science & Business Media
ISBN: 9401133808
Category : Philosophy
Languages : en
Pages : 242

Get Book Here

Book Description
The first time I read the medical consent and authorization. it had registered in my mind simply as a legal document. Now I began to understand what it meant. It was a letter of ultimate love and trust. (Schucking. 1985. p. 268) Ever since Karen Ann Quinlan slipped into permanent unconsciousness in 1975 and her father agonized publicly over whether she should remain indefinitely on a respirator (In re Quinlan, 1976), the desires of patients, their families, and their friends to limit the application of apparently limitless medical technology have been a pressing concern for ethics, law, and public policy. Ms. Quinlan's case contained nearly all the elements of the problems we still face: vague, general, but sincere prior oral statements suggesting that she would not want continued treatment; a family attempting to do what they saw as best for her; and physicians uncertain whether to use medical judgment alone (and if so, what the "right" medical decision was), to preserve her life at all costs, or to honor the family's interpretation of their daughter's choice. Most ironically, once she was removed from her respirator, she did not die. Karen Quinlan - like dozens of other names made famous by court decisions, newspaper stories, and television evening news - has come to symbolize a tangled knot of issues surrounding the end of life and who controls it.

Making Sense of Advance Directives

Making Sense of Advance Directives PDF Author: Nancy M.P. King
Publisher: Georgetown University Press
ISBN: 9780878406050
Category : Medical
Languages : en
Pages : 304

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Book Description
Advance directives—such as living wills and health care proxies—are documents intended to declare and preserve the health care choices of patients if they become unable to make their own decisions. This book provides a comprehensive overview of advance directives and clear, practical directions for writing and interpreting them. Nancy M.P. King provides a legal, philosophical, and historical analysis of the moral and legal force of advance directives. She explains the types and models of advance directives currently in use and offers guidelines for individuals seeking to write, read, and use directives to promote individuals' health care choices within the laws of their own states. King emphasizes that advance directives are not orders given by patients to their doctors; instead, they are documents that invite conversation between doctors and patients about health care decisions of great importance. The purpose of advance directives is to support patients' health care choices, and the book promotes a thoughtful use of advance directives that is best calculated to achieve that purpose, whatever form individual advance directives may take. This new edition has been updated to reflect the many changes in advance directive statutes since 1991, including expanded discussions of health care proxy statutes, the impact of the Patient Self-Determination Act and the Supreme Court's Cruzan decision. King also has extended her analysis of the implications for advance directives of managed care, resource allocation, resource scarcity, and the debate over futile treatment at the end of life. Making Sense of Advance Directives is a valuable handbook for patients, health care providers and administrators, patient counselors, lawyers, policymakers, and any individual interested in advance directives.

Dying in America

Dying in America PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309303133
Category : Medical
Languages : en
Pages : 470

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Book Description
For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

Measurement Tools in Clinical Ethics

Measurement Tools in Clinical Ethics PDF Author: Barbara Redman
Publisher: SAGE
ISBN: 0761915184
Category : Medical
Languages : en
Pages : 313

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Book Description
"The evolution of ethical issues in clinical and research work in health has acclerated dramatically due to the struggle toward patient automony in end-of-life decisions and patients' access to choices in health care and in research. How do we clarify the assumptions and consequences of these decisions in the development of measurement instruments that gather data of their psychometic characteristics? This book presents a number of these instruments ... each chapter examines a specific topic category (for example, patient preference, aggressiveness of care, and others) and then explains each of the various instruments that have been developed to measure that topic. Next, the description, psychometric properties, summary and critique, references, and a copy of the instrument are provided so as to facilitate the reader's search for a usable instrument."--Back cover.

Taking Advance Directives Seriously

Taking Advance Directives Seriously PDF Author: Robert S. Olick
Publisher: Georgetown University Press
ISBN: 9781589014176
Category : Medical
Languages : en
Pages : 252

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Book Description
In the quarter century since the landmark Karen Ann Quinlan case, an ethical, legal, and societal consensus supporting patients' rights to refuse life-sustaining treatment has become a cornerstone of bioethics. Patients now legally can write advance directives to govern their treatment decisions at a time of future incapacity, yet in clinical practice their wishes often are ignored. Examining the tension between incompetent patients' prior wishes and their current best interests as well as other challenges to advance directives, Robert S. Olick offers a comprehensive argument for favoring advance instructions during the dying process. He clarifies widespread confusion about the moral and legal weight of advance directives, and he prescribes changes in law, policy, and practice that would not only ensure that directives count in the care of the dying but also would define narrow instances when directives should not be followed. Olick also presents and develops an original theory of prospective autonomy that recasts and strengthens patient and family control. While focusing largely on philosophical issues the book devotes substantial attention to legal and policy questions and includes case studies throughout. An important resource for medical ethicists, lawyers, physicians, nurses, health care professionals, and patients' rights advocates, it champions the practical, ethical, and humane duty of taking advance directives seriously where it matters most-at the bedside of dying patients.

Advance Directives

Advance Directives PDF Author: Peter Lack
Publisher: Springer Science & Business Media
ISBN: 9400773773
Category : Medical
Languages : en
Pages : 214

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Book Description
This volume gives an overview on the currently debated ethical issues regarding advance directives from an international perspective. It focuses on a wider understanding of the known and widely accepted concept of patient self-determination for future situations. Although advance directives have been widely discussed since the 1980s, the ethical bases of advance directives still remain a matter of heated debates. The book aims to contribute to these controversial debates by integrating fundamental ethical issues on advance directives with practical matters of their implementation. Cultural, national and professional differences in how advance directives are understood by health care professions and by patients, as well as in laws and regulations, are pinpointed.

Dementia and the Advance Directive

Dementia and the Advance Directive PDF Author: Marcia Sokolowski
Publisher: Springer
ISBN: 331972083X
Category : Medical
Languages : en
Pages : 147

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Book Description
This unique title offers a novel exploration into the world of advance directives for patients with dementia. Based on real life ethics consultations the expert author has undertaken, the cases depict fascinating and challenging moral issues arising in a variety of healthcare facilities. The dynamics of the interdisciplinary health care teams of these patients, along with the dynamics of the families who are grappling to best serve their loved ones, are outlined and assessed; and the role each player’s personal histories have on the ethical issues and their resolution in real life are explored. Following each case study, the author applies a range of concepts introduced in the beginning of the book to the relevant case study, thus integrating theory with a case-based approach. A user-friendly question-and-answer format provides a thought provoking and accessible learning experience for readers. Dementia and the Advance Directive: Lessons from the Bedside tackles complicated and realistic healthcare scenarios and offers an invaluable addition to the literature on advance directives.

Advance Directives in Mental Health

Advance Directives in Mental Health PDF Author: Jacqueline Atkinson
Publisher: Jessica Kingsley Publishers
ISBN: 1846426685
Category : Medical
Languages : en
Pages : 217

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Book Description
An advance directive is a way of making a person's views known if he or she should become mentally incapable of giving consent to treatment, or making informed choices about treatment, at some future time. Advance Directives in Mental Health is a comprehensive and accessible guide for mental health professionals advising service users on their choices about treatment in the event of future episodes of mental illness, covering all ideological, legal and medical aspects of advance directives. Jacqueline Atkinson explains their origins and significance in the context of mental health legislation and compares advance directives in mental health with those in other areas of medicine like dementia or terminal illness, offering a general overview of the differences in the laws of various English-speaking countries. She explores issues of autonomy and responsibility in mental health and gives practical advice on how to set up, implement and change advance directives. The book offers a useful overview of advance directives and is a key reference for all mental health professionals as well as postgraduate students, lawyers who work with mentally ill people, service users and their families and carers.

Advance Directives and the Pursuit of Death with Dignity

Advance Directives and the Pursuit of Death with Dignity PDF Author: Norman L. Cantor
Publisher: Indiana University Press
ISBN: 9780253113825
Category : Law
Languages : en
Pages : 230

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Book Description
"[Cantor provides] both a cogent and provocative text and prodigious references." -- The New England Journal of Medicine "Cantor develops a careful and accessible ethic of autonomy and dignity regarding forgoing life-prolonging medical treatment... " -- Ethics "A thoughtful, informative and sensitive text... " -- European Medical Journal "Professor Cantor of Rutgers University School of Law has created a scholarly and sophisticated, yet quite accessible, legal analysis of the subject of advance directives... detailed, exhaustively referenced... " -- The Florida Bar Journal "This book is an excellent resource for anyone interested in learning about advance directives for health care." -- Doody's Health Sciences Book Review Journal "Cantor provides a very thorough, reliable, and readable guide... " -- Robert M. Veatch, Director, Kennedy Institute of Ethics, Georgetown University Cantor examines the medical, legal, and moral issues surrounding advance medical directives -- those devices aimed at controlling medical intervention during the dying process after the patient is no longer competent.