Ella Miller Final paper

Grandmother Ella has been dealing with cancer for years now and has tried alternative remedies and juicing. She went into remission for some time, but now the cancer has returned and she is in the hospital. Her husband, of American Indian descent, has his ideas about what needs to be done as Ella comes to the end of her life. Ella has her preferences, though she is now so weak that she has given up in many ways. The family members are each

Patient self- Determination Act (PSDA) encourages people to make a decision about the extent of medical care they want to accept or refuse (American Cancer Society, 2015). It is the responsibility of ethics committee to make patients aware of their rights. Also, “committee members need to be educational and advisory in nature, they should educate themselves, other health care workers, patients and the family members regarding the ethical principles and organization’s policy relating to the ethical issues”(Alexander & Kavaler, 2014). Many people are not aware with the advance directives, they don’t know how to complete advance directives (ADs), what are the state regulation to complete ADs and only a few people discuss their preferences with doctor, which do not protect their autonomy during the time of end- of- life (House & Lach, 2014). Health care professionals must be competent to provide information on ADs so that patients will be able to make a decision. In addition, patient’s wishes and ADs need to be discussed among family members and the health care providers so ethics committee plays an integral role in protecting patients’ preferences and supporting ADs process for

End of Life Care Planning is a controversial topic that is huge dilemma in healthcare. The average Medicare expenditures per person over the last two years of life was $102, 939.00 (Harter, 2015). One quarter of traditional Medicare spending for health care is for services provided to Medicare beneficiaries in their last year of life (The Henry J. Kaiser Family Foundation, 2016). Nurses deal with ethical dilemmas when caring for patients at the end of life. Nurses are responsible in minimizing unwanted treatment and patient suffering, which can sometimes be interfered by what family members want and the patient wishes (American Nurses Association [ANA], 2012). This paper will go over why end of life care planning should and should be covered as a covered expense.

Autonomy in society is greatly valued. Despite this, there is a limit to the amount of autonomy allowed to an individual; for instance, the autonomy to die in a medical setting is heavily restricted. Chapter 7 covers the issue of how physicians decide who can be permitted to die.

End of life decisions are very important because in some cases people lose the ability to provide informed consent for their medical treatment. If someone was unable to make his or her own health care decisions it becomes the responsibility of his or her designated surrogate. For example when someone is pronounced in a persistent vegetative state their health care surrogate would determine what kind of life prolonging procedures should be provided. During some point throughout a person’s lifetime it’s significant they make a Living Will that lists all of their intentions that will be respected by their family, friends and physicians. I chose to write about this topic because I recently created my own Living Will and had it signed by witnesses and documented incase I become incapacitated to express what treatment I want.

Almost all states have statutes supporting the right of adult patients to refuse care and to provide directives about end-of-life care when patient unable to make decisions. The United States Supreme Court also has recognized that the constitution gives competent adults can refuse unwanted medical treatment (Koppel & Sullivan, 2011). Uniform Right of the Terminally Ill Act of 1989 enacted the permission of an individual to execute a declaration that guides a healthcare provider (physician) to withdraw life-sustaining treatment when a patient is in terminally ill condition and unable to make decisions Withdrawal of life-sustaining treatment is not applicable without the approval of patient or surrogates. (Houghton & Lombard, 1990). “Patient Self-Determination Act of 1990 was enacted to ensure that patients are informed of their

The ten areas included, symptoms, social supports, communication with health providers, spiritual meaning, care needs, end of life plans, economic burdens, sociodemographics, preferences regarding end-of-life care and euthanasia and assisted suicide, and stress of the interview (Ezekiel et al., 2000). The findings from the surveys showed that in hypothetical scenarios, 60.2% of the terminally ill patients supported euthanasia or assisted suicide, despite the fact that only 10.6% of the patients seriously contemplated it for themselves (Ezekiel et al., 2000). Many factors play into individuals choosing not to take their own life, even if they believe that others should have the right to. For example, the patients that had loved ones present in their lives were not as likely to take their own lives, but the patients that were alone, causing them to be depressed, as well as the patients who needed more intense care, were much more likely to see euthanasia or assisted suicide as a legitimate option (Ezekiel et al., 2000). 58.7% of the caregivers supported the use of euthanasia for their patients who were in pain (Ezekiel et al., 2000). After the surveys were completed, follow up interviews were conducted six months later in order to see how the patients and caregivers views might have changed (Ezekiel et al., 2000).

out-of-pocket expenditures rise along with their increasing medical needs. In addition, there is a gap between potential treatments available and the care that people prefer to receive near the end of life. Furthermore, studies have shown that most people prefer to die under their terms with having the final say. (Sion L. Kim BS, Derjung M. Tarn MD, PHD,

Making decisions for patients are difficult in general, but the decisions for end-of-life is the most challenging because it is tough and it involves family. Although we want to remain the autonomy of the patient, but I can empathize the hardship of the loved ones being able to let go. As a healthcare provider, the reasonable and ethical thing to do is to be completely honest about their condition and prognosis, then assist them to the best of our capabilities. I agree with Gawande (2014) that there is always something we can do. Whether the patient decides to fight the battle or to manage their symptoms to treasure the remaining time, nurses should and will respect their decisions.

In any health care setting it is crucial that the patients’ autonomy be respected and abided by, this is especially critical when the patients’ end of life care is being

End-of-life care can be defined as the care of a patient from the moment healthcare team members have doubts about the purpose of life-sustaining treatment until the care for family after death of the patient (Noome, 2016). Caring for patients with life-threatening illnesses is extraordinarily challenging. When caring for a patient in their last days, nurses may encounter legal aspects of care that they may not be familiar with. The main objectives of this paper is to identify and discuss legal aspects of end-of-life care, compromised autonomy of the patient, and nurse perspectives on end-of-life care

About a century ago, when new technologies such as the artificial respirator and morphine spiked, the right to die law came up. The right to die law gives terminally ill patients the ability to end their life. Today, in the United States only five states have passed the right to die law. All terminally ill patients, should have the option open to them in all fifty states. With the right to die law comes a variety of opinions, along with uprising questions, and stories of people who did or should have been able to chose their death.

American’s love to plan their life, whether we plan our work schedules, school, college, vacations, weddings and retirements. We sit down with an attorney for our final estate. The one area we don’t plan is our end of life wishes; nobody likes to think of this. They think it’s a lifetime away and that the thoughts are unpleasant. When we don’t think about this topic and share with our loved ones, professionals will take over when we are the most vulnerable. Everyone wants and wishes to die with dignity. Most individuals want the right to make their own decisions when it comes to medicine and right to life. The doctor’s who care for patients treat them how they think a patient should be treated often times this results in lack of empathy. Some

terminal disease, many patients wish they could have the autonomy to end their lives at a time of

Opponents to euthanasia argue that if it is legalized voluntary euthanasia will soon give way to involuntary or coerced euthanasia. However, this can also be argued that a patient can make their choice on life or death to avoid imposing overly heavy burdens of care and support on family members or loved ones (Humber and Almeder 5). While this may or may not be a legitimate concern, it does not change the fact that a terminally ill patient is only prolonging the unavoidable by not being given the choice of euthanasia. Yet a patient requiring extensive care should also be able to decide that if they do not want the care, they have an option to pass without suffering from whatever condition they may have. This implication mainly applies to elderly patients who have already lived full lives, especially those suffering from diseases like Alzheimer’s or Huntington’s, and whose suffering would also lead to the misery of their loved ones. Any logical thinker would understand that a patient in these circumstances should be able to make the choice to be willing to die to prevent damaging the futures of their loved ones versus buying a little more time for himself or herself. As a person who watched one of my dearest family member’s struggle with Alzheimer’s, fight the pain day after day, not be able to function for daily tasks, and lose all of his dignity and will to live; I wish