Leah L. Markley
Health Rights and Responsibilities
March 25, 2011
Advance Directives: Patient End-of-Life Decisions 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). According to the American Cancer Society (2009), the PSDA “encourages everyone to decide now about the types and extent of medical care they want to accept or refuse if they become unable to make those decisions due to illness. The PSDA requires all health care agencies to recognize the living will and durable power of attorney for health care.” Advance directives are a means by which an individual can provide their own unique instructions for their medical care should they become unable to do so for themselves.
Advance Directives Defined According to Medline (2011), “Advance directives are legal documents that allow you to convey your decisions about end-of-life care ahead of time. They provide a way for you to communicate your wishes to family, friends and health care professionals, and to avoid confusion later on.” Legal requirements vary from state to state as to what is included, whether or not witnesses are necessary, and what can be designated. It is best that these documents be drawn prior to becoming ill or incapacitated so that there are limited questions as to how to handle one’s care. Three different types of advance directives for medical care are available. First, a living will allows you to make specific
References: American Cancer Society (2009). Advance directive topics. The patient self-determination act (PSDA). Retrieved from http://www.cancer.org/Treatment/FindingandPayingforTreatment/UnderstandingFinancialandLegalMatters/AdvanceDirectives/advance-directives-patient-self-determination-act Fremgen, B. (2009). Medical Law and Ethics. Upper Saddle River, NJ:Pearson Prentice Hall. Medline Plus (2011). A service of the U.S. National Library of Medicine NIH National Institutes of Health. Advance Directives. Retrieved from http://www.nlm.nih.gov/medlineplus/advancedirectives.html National Hospice and Palliative Care Organization (2010). Caring Connections. California advance directive planning for important health care decisions. Retrieved from http://www.caringinfo.org/files/public/ad/California.pdf Pace, Brian, MA. (November 15, 2000). JAMA patient page:Decisions about end-of-life care. The Journal of the American Medical Association. Vol 284, No. 19. Retrieved from http://jama.ama-assn.org/content/284/19/2550.full.pdf