Discussion Questions Recent Effort To Give People Some Contr

Discussion Questiona Recent Effort To Give People Some Control Of Tr

A recent effort to give people some control of treatment decisions at the end of life is "Five Wishes." It is a living will tool that talks about personal, emotional and spiritual needs as well as medical treatment wishes. After reading this tool and the material of this module, what insights have you gained about the importance and value of advance directives? Would you consider using such a format for your own important health care planning? Why or why not? Practical Decision Making in Health Care Ethics: Cases and Concepts , Chapters 4 and 5, pp. 70-120 (Guiding thoughts.) The most celebrated case of withdrawing a patient from hydration and nutrition, until the Terri Schiavo case (Devettere p. ), was the case of Nancy Cruzan. Her case went to the Supreme Court. In 1990, it ruled "that Missouri's insistence on clear and convincing evidence before a proxy could have a feeding tube removed was not so strict that it violated the Constitution. It also noted that no clear and convincing evidence is yet found in the case. In effect, the court ruled that medical nutrition and hydration could not be withdrawn" (Devettere 297). The family returned to the Missouri court of judge Teel. He upheld his original decision to withdraw treatment, but this time, based upon what he judged as clear and convincing evidence of new witnesses. This short review of these important precedent-setting cases should lead one to recognize the value of having advance directive which includes the power of attorney.

Paper For Above instruction

Advance directives have become a pivotal element in modern healthcare, offering individuals a method to assert their treatment preferences should they become incapacitated and unable to communicate. Tools like "Five Wishes" exemplify how these directives can encompass not only medical decisions but also personal, emotional, and spiritual considerations, thereby respecting the holistic nature of patient autonomy. The significance of advance directives lies in their capacity to facilitate patient-centered care, alleviate the burden on families and healthcare providers, and ensure that treatment aligns with the individual's values and wishes, particularly in complex end-of-life scenarios.

The case of Nancy Cruzan, along with the landmark Supreme Court decision in 1990, underscores the critical importance of having legally recognized advance directives. Cruzan's case highlighted that without clear and convincing evidence of a patient’s wishes, healthcare providers could be compelled to continue life-sustaining treatments, even if they conflicted with the patient’s preferences. The court's ruling established the necessity of documented evidence, such as living wills or durable powers of attorney, to confidently honor a patient's treatment choices. These legal precedents emphasize that advance directives are not only ethical instruments but also vital safeguards that uphold individual autonomy and provide clear guidance to medical professionals and families during emotionally charged situations.

From a personal perspective, I would consider using a format like "Five Wishes" for my own health care planning. This comprehensive approach addresses more than just medical interventions; it explores emotional, spiritual, and personal themes that are often overlooked in traditional directives. Such a format fosters open dialogue with loved ones and healthcare providers, ensuring that my values are respected even when I cannot communicate them myself. It also encourages proactive thinking about future health care decisions, which can reduce uncertainty, anxiety, and potential conflicts among family members. Recognizing the importance of detailed instructions and documented preferences, I believe adopting a structured and holistic advance directive is a prudent step toward preserving my dignity and autonomy in health crises.

In conclusion, the evolution of advance directives like "Five Wishes" affirms their role as essential tools in ethical medical decision-making. Case law, such as that involving Nancy Cruzan, illustrates the necessity of legally binding wishes to navigate complex end-of-life choices effectively. Embracing comprehensive and thoughtful advance directives not only affirms individual autonomy but also ensures that healthcare providers and families can make decisions aligned with the patient’s true desires, thereby honoring their dignity and humanity in life's final stages.

References

• Devettere, R. J. (2015). Practical Decision Making in Health Care Ethics: Cases and Concepts. McGraw-Hill Education.
• Reingold, A. L., & Goldman, M. (2004). The Emerging Role of Advance Directives in Health Care. Journal of the American Medical Association, 291(10), 1204–1209.
• Sudore, R. L., & Fried, T. R. (2010). Redefining the "Planning" in Advance Care Planning: Preparing for Long-Term Care. JAMA Internal Medicine, 170(9), 781–782.
• Goals of Care. (2014). Five Wishes: Personal, Emotional, and Spiritual Needs in End-of-Life Planning. Aging with Dignity.
• California Legal Requirements for Living Wills and Power of Attorney. (2021). California Department of Public Health.
• Henderson, L. W. (1992). The Ethics of End-of-Life Decision Making. The Journal of Clinical Ethics, 3(3), 189–194.
• Snyder, L., & Stevenson, F. (2007). Ethical and Legal Considerations in End-of-Life Care. Nursing Clinics of North America, 42(2), 261–271.
• Cocke, C. (2013). Legal and Ethical Issues in End-of-Life Care. American Journal of Hospice & Palliative Medicine, 30(4), 357–362.
• Vettese, L. (1999). Living Wills and Advance Directives: Ethical and Legal Perspectives. Health Law Journal, 12(2), 45–54.
• Hasson, F., & Murnion, C. (2006). Advance Directives and End-of-Life Decision Making in Healthcare. International Journal of Palliative Nursing, 12(2), 72–77.