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Advanced Directives

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Advanced Directives
Health Care Institutional Organization and Management

Individual Paper #2

June 25, 2006

Imagine laying in a hospital intensive care unit critically injured, unconscious, yet fully aware of your surroundings but unable to interact. Imagine hearing your family discussing with the doctors your slim potential for recovery or insurance coverage running out and you can not articulate your wishes to continue treatment. In a situation like this, advanced directives provide the hospital, the staff, and your family the necessary guidance to authorize the use or withdraw of medical procedures. According to the Federal Patient Self Determination Act of 1990, advanced directives are "an individual 's rights under State law to make decisions concerning such medical care, including the right to accept or refuse medical or surgical treatment" and such directives will ensure that the patient 's wishes are followed to either conduct procedures to save your life or no procedures to allow you to pass on. In either case, advanced directives are an extremely important step in patient health care in providing quality service to the patient and relieving the physician from liability if some people do not agree with the advanced directives. Advance directives also assist the hospital staff in making the correct and ethical decision for the patient. In these critical situations, there are "ethical duties that physicians owe to their patients: the obligation to respect a competent patient 's right to refuse medical treatment in accordance with his/her own values and beliefs…the obligation to engage in a process of communication that adequately prepares the patient to make an informed decision". The process of creating advanced directives provides the patient the communication to make an informed decision, which also allows the physician to make an ethical decision. Though advanced directives seem fairly "cut and dry", there are some problems. Many patients who



Bibliography: Berns, Walter (1953, Dec). Buck v. Bell: Due Process of the Law?. Western Political Quarterly, Vol. 6 No.4, Retrieved June 2006, from http://links.jstor.org/sici?sici=0043-4078(195312)6%3A4%3C762%3ABVBDPO%3E2.0.CO%3B2-S Clay, Marjorie Ann (1999, January). Ethical and Legal Implications of Bloodless Medicine and Surgery. Journal of Intensive Care Medicine, 14, Retrieved June 2006, from http://www.blackwell-synergy.com/links/doi/10.1046/j.1525-1489.1999.00034.x Darr, Kurt, Longest, Beaufort B. Jr., Rakich, Jonathan S. (4th Ed.). (2000). Managing Health Services Organizations and Systems. Baltimore: Health Professional Press. Fitzerald, Patrick, Krueger, Kurt V. (2005, Nov 19). Tort Remedy in the Law Versus Economic Restitution for Personal Injury and Wrongful Death. South Economic Association 75th Annual Meeting, Retrieved June 2006, from http://johnwardeconomics.com/Research%20and%20Data/Tort%20Remedy%20v%20Economic%20Restitution.pdf Miller, Robert D., Hutton, Rebecca C. Problems in Health Care Law (8th Ed.). (2000). Gaithersburg: An Aspen Publication. Pennsylvania Supreme Court, (1985, Dec 27). In re Estate of Dorone. 502, Retrieved June 2006, from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11648262&dopt=Citation Pullman, Daryl, Xikui, Wang (2001, February). Informed Consent and the Dynamics of Moral Responsibility. Adaptive Designs, Informed Consent, and the Ethics of Research, Retrieved June 2006, from http://home.cc.umanitoba.ca/~wangx1/CCT2001.pdf Requirements for Advanced Directives Under State Plans for Medical Assistance. Patient Self Determination Act of 1990, Retrieved June 2006, from http://www.fha.org/acrobat/Patient%20Self%20Determination%20Act%201990.pdf Skelly, F.J. (1994, Aug). The payoff of informed consent. AM. Med. News. University of Minnesota, (1997, July). Withdrawing or Withholding Artficial Nutrition and Hydration. Center for Bioethics, Retrieved June 2006, from http://www.med.umn.edu/bioethics/publications/RP2.pdf

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