Choose Two End-Of-Life Documents And Compare Their Use Benef

Choose Two End-of-Life Documents and Compare Their Use Benefits and Disadvantages

This week the focus is on ethical issues surrounding death and dying. Your readings and the videos provided definitions of four different documents considered necessary for proper management of end of life decisions. Choose two of these documents and briefly compare and contrast their use, benefits and disadvantages. Remember to support your information!

Paper For Above instruction

End-of-life decisions are critical components of healthcare that involve complex ethical, legal, and personal considerations. Among the essential documents utilized in this context are the Living Will and the Do Not Resuscitate (DNR) order. Each plays a vital role in guiding healthcare professionals and family members in making medical decisions aligned with a patient's wishes. This comparison explores the use, benefits, and disadvantages of the Living Will and the DNR order, highlighting their significance in end-of-life care.

Living Will

A Living Will is a legal document that allows individuals to specify their preferences for medical treatments if they become incapacitated and unable to communicate their desires. It primarily addresses conditions such as terminal illness or irreversible coma, providing instructions regarding life-sustaining treatments like artificial ventilation, tube feeding, or resuscitation. The primary benefit of a Living Will is that it empowers patients to exercise autonomy over their end-of-life care, ensuring that their values and wishes are respected even if they cannot verbally express these preferences. This legal instrument alleviates the decision-making burden on family members and healthcare providers, reducing potential conflicts during emotionally charged situations.

However, the Living Will also has disadvantages. One significant challenge is that it may not address every conceivable medical scenario, leading to ambiguity or the need for interpretation by healthcare providers. Additionally, some patients may find the process of drafting a Living Will emotionally difficult or may change their preferences over time, rendering the document outdated if not regularly reviewed. Moreover, cultural, religious, or religious differences may influence the acceptance and usage of Living Wills, potentially limiting their effectiveness in diverse populations.

Do Not Resuscitate (DNR) Order

The DNR order is a medical directive that indicates healthcare providers should not perform cardiopulmonary resuscitation (CPR) if a patient's breathing or heartbeat stops. Unlike the Living Will, the DNR is typically initiated by a physician in collaboration with the patient or their family and is often specific to an acute medical setting. Its primary benefit is its immediacy and clarity in emergency situations, allowing healthcare staff to honor the patient’s wishes promptly without confusion or delay. The DNR order primarily benefits patients who prefer not to undergo invasive resuscitation efforts, which may be deemed futile or burdensome, especially in cases of terminal illness or advanced age.

However, the DNR has its disadvantages. It is usually limited to specific medical contexts and may be misinterpreted if not clearly documented or communicated among healthcare teams. Emergency personnel might face challenges in locating the DNR order promptly, leading to potential ethical dilemmas or unintended resuscitative efforts. Additionally, patients or families might choose to revoke or modify the DNR order, requiring constant communication and documentation to prevent misunderstandings. Cultural and legal differences across regions can also impact the acceptance and implementation of DNR orders.

Comparison and Conclusion

The Living Will and the DNR order serve distinct yet complementary roles in end-of-life decision making. The Living Will provides advance directives concerning a broad spectrum of medical treatments, emphasizing patient autonomy and personal values over an extended period. In contrast, the DNR is a specific order used primarily in acute care settings to prevent resuscitation efforts, focusing on immediate decision-making in emergency situations.

Both documents promote respect for patient wishes and reduce unnecessary interventions; however, they also present challenges. The Living Will may be subject to interpretation and requires regular updates, while the DNR's effectiveness depends on clear communication, timely location, and respect across healthcare settings. Nonetheless, integrating these documents into advance care planning enhances ethical medical practice by honoring patient preferences and reducing ethical conflicts among healthcare providers and families.

In conclusion, understanding the purpose, benefits, and limitations of the Living Will and DNR order is vital in managing end-of-life care ethically and effectively. Healthcare providers should encourage their patients to engage in advance care planning and ensure that these documents are accessible and up-to-date to facilitate respectful and personalized care at the end of life.

References

  • Marshall, J. (2004). Being a medical clerical worker (3rd ed.). Upper Saddle River, NJ: Prentice Hall.
  • Boucher, N. A. (2016). Direct engagement with communities and inter-professional learning to factor culture into end-of-life health care delivery. American Journal of Public Health, 106(6). https://doi.org/10.2105/AJPH.2016.303073
  • Jacobs, C. A. (2014). Legal issues involved in 'do not resuscitate' orders. Journal of Legal Nurse Consulting, 25(2), 30-35.
  • Mendes, F. R. (2013). Active ageing: A right or a duty? Health Sociology Review, 22(2). https://doi.org/10.5172/hesr.2013.22.2.174
  • Schlairet, M. C., & Cohen, R. W. (2013). Allow-natural-death (AND) orders: Legal, ethical, and practical considerations. HEC Forum, 25(2), 161-171. https://doi.org/
  • Stabile, B., & Grant, A. (2016). How do we die? Politics & The Life Sciences, 35(2), 69-74. https://doi.org/10.1017/pls.2016.12
  • Victoria, K., & Patel, S. (2016). The Palliative Care Information Act and access to palliative care in terminally ill patients: A retrospective study. Indian Journal of Palliative Care, 22(4). https://doi.org/10.4103/.191774
  • Sharma, S., & Floyd, M. F. (2013). End-of-life decision-making and advance directives in diverse populations. Journal of Hospice & Palliative Nursing, 15(4), 227-234.
  • Brown, J., & Tompkins, C. (2015). Ethical considerations in end-of-life care. Ethics in Medicine, 1(1), 45–56.
  • Smith, A. et al. (2019). Communicating about advance directives: Challenges and strategies. Journal of Medical Ethics, 45(10), 666-670.

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