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Legal and Ethical Issues Affecting End-Of-Life Care: Advance Directives

This document discusses legal and ethical issues surrounding end-of-life care, including advance directives. It defines advance directives as documents that provide instructions for future medical care and treatments. Common types of advance directives mentioned are living wills, Do Not Resuscitate orders, and documents appointing a health care agent. The document also discusses a nurse's responsibilities in caring for dying patients, which include being aware of the patient's wishes, providing holistic care, and respecting the patient and family.

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erwin kurniawan
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182 views

Legal and Ethical Issues Affecting End-Of-Life Care: Advance Directives

This document discusses legal and ethical issues surrounding end-of-life care, including advance directives. It defines advance directives as documents that provide instructions for future medical care and treatments. Common types of advance directives mentioned are living wills, Do Not Resuscitate orders, and documents appointing a health care agent. The document also discusses a nurse's responsibilities in caring for dying patients, which include being aware of the patient's wishes, providing holistic care, and respecting the patient and family.

Uploaded by

erwin kurniawan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Legal and Ethical Issues

Affecting End-of-life Care


Advance Directives

The Issues
The outcomes related to their
care should be their own
wishes.
The decisions may involve the
choice for:
Organ and tissue donations
Advance directives
Resuscitation

Advance Directives
A general term used to describe the
documents that give instructions
about future medical care and
treatments
Advance Directives include:
Living Will
Do Not Resuscitate Order
Withholding or Withdrawing Treatments

Living Will
Was the first advance directive
The lay term used frequently to describe
any number of documents that give
instructions about future medical care and
treatments or the wish to be allowed to die
without heroic or extraordinary measures
should the patient be unable to
communicate for self
Most states have replaced the idea of living
wills with the natural death acts
These include:
Directive to physicians (DTP)
Durable power of attorney for health care (DPAHC)
Medical power of attorney (MPOA)

Directive to physicians
A written document specifying
the patients wish to be
allowed to die without heroic
or extraordinary measures

Durable power of attorney for


health care
A term used by some states to
describe a document used for
listing the person or persons to
make health care decision should
a patient become unable to make
informed decisions for self.

Medical power of attorney


Same as durable power of
attorney for health (depends on
state)
Person appointed may be called
a health care agent, surrogate,
attorney-in-fact, or proxy

Do Not Resuscitate
A written physicians order instructing
health care providers not to attempt CPR
Often requested by family
Must be signed my a physician to be valid
Several types of CPR decisions can be
made, including:

Full code
Chemical code
DNR or no code
Out-of-hospital DNR

Full code
Complete and total heroic measures,
which may include CPR, drugs, and
mechanical ventilation

Chemical code

The use of drugs for resuscitation


without the use of CPR

DNR or no code
Allows the person to die with comfort measures
only and without the interference of technology
Becoming known as allow natural death (AND)
or comfort code

Out-of-hospital DNR

For use by terminally ill patients who wish


to have no heroic measures used to
prolong life after they leave an acute care
facility

Withholding or withdrawing
treatments
What is to be done and what is not to be
done must be included in clear terms
Honoring the refusal of treatments that a
patient does not desire, are
disproportionately burdensome to the
patient, or will not benefit the patient can
be ethically and legally permissible
The decision to withhold artificial nutrition
and hydration should be made by the
patient or surrogate with the health care
team

The Nurses Responsibilities


Be aware of legal issues and the wishes of
the patient
Nursing care of dying patients is holistic and
encompasses all aspects of psychosocial
(grieving process) and physical needs
(physical changes that are associated with
dying)
Focus on patient and family: respect,
dignity, and comfort
Recognize own needs when dealing with
grief and dying.

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