University of Chicago
Type of paper: Thesis/Dissertation Chapter
Legal and Ethical Basis for Advance Directives
Advance directives could be defines as the legal documents that allow a person to convey his/her decisions about the end-of life care. In other terms, advance directives are the documents, which are used to communicate the wishes of a person about his/her health care decision in the conditions in which that person has become unable to make healthcare decisions (Meisel & Cerminara, 2004). It is the expressions of a living in advance or the preferences/instructions of that person for health care. Advance directives could be of two types one is living wills and other is durable powers of attorney for health care. Advance directives are formed with legislative actions if they are constructed as per the legal requirements. These directives are legally recognized documents, which have important consequence over the future heal care conditions.
It should be formed with the help of a legal advisor in a proper manner as it is the reflection of an individual’s future health treatment preferences (Klingensmith et.al, 2007). It is only determined valid, if it is designed with compliance of state law. Many states have specific forms for directives, which are required to fill by people interested in making advance directives. On the other hand, some states require writing advance directives in a standardized way (Meisel & Cerminara, 2004). There are some ethical bases also for advance directives. It is essential for medical professionals to keep the information of advance directives confidential as far as that individual is able to make decisions for future health care (Voltz, et.al, 2004).
The medical team is also require to take consent of family members as sometimes family members have issue on the authority of patient’s living will. Thus, this issue should be solved with family members. At the same time, it should be understood that advance directive do not include all conceivable end-of life decisions. So, it is essential to form the advance directives with clear terms and their interpretations should be also be in true manner (Rai, 2004). Ethical basis allows physicians to determine when to follow the advance directives and when they should be questioned. Situation for Living Will
Living will is the health care declaration for the type of medical treatment and life sustaining measures. In this a person describes his/her preferences for a specific medical treatment. This living will can be applied broadly in two categories one is terminal illness and another is permanent disability. Terminal illness is the situation in which death is expected in a short-time (Stoppe, 2007). On the other hand, permanent disability is the situation in which competency of patient for giving instructions ended. Living will only applies in the situations, where death is imminent. If you are unable to make medical decisions but your death is not imminent then living will cannot be applied. It is because living will does not appoint an agent on behalf of patient (Rosenthal, Zenilman & Katlic, 2011).
A living will might be applied in the situation in which people suffer from terminal illness. The treatment in terminal illness only extends life, while some people often fear about the treatment, which extends life only without restoring the quality life. It is because this type of treatment is acceptable for some people, while for other it is not acceptable. In this type of situation, living will might be applied (Rosenthal, Zenilman & Katlic, 2011). If the patient loses the ability to communicate then doctors may act as per the living will of him/her.
In the situation of terminal illness, doctors may assume that patients’ life should be extended as long as possible due to communication disability. On the other hand, patient can request shorter but comfortable life during terminal illness (Stoppe, 2007). It depends on their preference for their medical treatment. In this situation, doctors can work as per health care declarations on patient’s wishes. Thus, in this situation of terminal illness, the living will might be applied and patients would be treated as per their wishes for health care treatment.
Sample Living Will
Date and Year | Declaration made this………………day of………., year………… | Name with standard language| I, ………………………, willfully and voluntary make known my desire that my dying not be artificially prolonged under the circumstances set forth below, and I do hereby declare:| Declaration| If at any time, I have a terminal illness and if my treating physician and another consulting physician have determined that there is no probability for recovery from such condition, I direct that life prolonging procedures should be withdrawn, which would serve to prolong artificially the process of dying. I will be permitted to die naturally with only the administration of medication or any medical process, which is essential to live with comfort care by alleviating pain.
Klingensmith, M.E., Chen, L.E., Glasgow, S.C., Goers, T.A. & Melby, S.J.
(2007). The Washington Manual of Surgery: Department of Surgery, Washington University School of Medicine, St. Louis, MO (5th ed.). USA: Lippincott Williams & Wilkins. Meisel, A. & Cerminara, K.L. (2004). The Right to Die: The Law of End-Of-Life Decisionmaking (3rd ed.). USA: Aspen Publishers Online. Rai, G.S. (2004). Medical Ethics And the Elderly (2nd ed.). Radcliffe Publishing. Rosenthal, R.A., Zenilman, M.E. & Katlic, M.R. (2011). Principles and Practice of Geriatric Surgery (2nd ed.). USA: Springer. Stoppe, G. (2007). Competence Assessment in Dementia. USA: Springer. Voltz, R., Bernat, J.L., Borasio, G.D., Maddocks, I., Oliver, D. & Portenoy, R.K. (2004). Palliative Care in Neurology. USA: Oxford University Press. White, L. (2005). Foundations Of Nursing (2nd ed.). USA: Cengage Learning.