Taking Advance Directives Seriously

Taking Advance Directives Seriously

Author: Robert S. Olick

Publisher:

Published: 2004

Total Pages: 228

ISBN-13: 9781589010291

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In the quarter century since the landmark Karen Ann Quinlan case, an ethical, legal, and societal consensus supporting patients' rights to refuse life-sustaining treatment has become a cornerstone of bioethics. Patients now legally can write advance directives to govern their treatment decisions at a time of future incapacity, yet in clinical practice their wishes often are ignored. Examining the tension between incompetent patients' prior wishes and their current best interests as well as other challenges to advance directives, Robert S. Olick offers a comprehensive argument for favoring advance instructions during the dying process. He clarifies widespread confusion about the moral and legal weight of advance directives, and he prescribes changes in law, policy, and practice that would not only ensure that directives count in the care of the dying but also would define narrow instances when directives should not be followed. Olick also presents and develops an original theory of prospective autonomy that recasts and strengthens patient and family control. While focusing largely on philosophical issues the book devotes substantial attention to legal and policy questions and includes case studies throughout. An important resource for medical ethicists, lawyers, physicians, nurses, health care professionals, and patients' rights advocates, it champions the practical, ethical, and humane duty of taking advance directives seriously where it matters most-at the bedside of dying patients.


Taking Advance Directives Seriously

Taking Advance Directives Seriously

Author: Robert S. Olick

Publisher: Georgetown University Press

Published: 2001-07-18

Total Pages: 252

ISBN-13: 9781589014176

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In the quarter century since the landmark Karen Ann Quinlan case, an ethical, legal, and societal consensus supporting patients' rights to refuse life-sustaining treatment has become a cornerstone of bioethics. Patients now legally can write advance directives to govern their treatment decisions at a time of future incapacity, yet in clinical practice their wishes often are ignored. Examining the tension between incompetent patients' prior wishes and their current best interests as well as other challenges to advance directives, Robert S. Olick offers a comprehensive argument for favoring advance instructions during the dying process. He clarifies widespread confusion about the moral and legal weight of advance directives, and he prescribes changes in law, policy, and practice that would not only ensure that directives count in the care of the dying but also would define narrow instances when directives should not be followed. Olick also presents and develops an original theory of prospective autonomy that recasts and strengthens patient and family control. While focusing largely on philosophical issues the book devotes substantial attention to legal and policy questions and includes case studies throughout. An important resource for medical ethicists, lawyers, physicians, nurses, health care professionals, and patients' rights advocates, it champions the practical, ethical, and humane duty of taking advance directives seriously where it matters most-at the bedside of dying patients.


Dying in America

Dying in America

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2015-03-19

Total Pages: 470

ISBN-13: 0309303133

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For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.


Deciding for Others

Deciding for Others

Author: Allen E. Buchanan

Publisher: Cambridge University Press

Published: 1989

Total Pages: 450

ISBN-13: 9780521311960

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This book is the most comprehensive treatment available of one of the most urgent problems in bioethics: decision-making for incompetents.


The Patient Self-Determination Act

The Patient Self-Determination Act

Author: Lawrence P. Ulrich

Publisher: Georgetown University Press

Published: 2001-07-18

Total Pages: 370

ISBN-13: 9781589014534

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The Patient Self-Determination Act of 1990 required medical facilities to provide patients with written notification of their right to refuse or consent to medical treatment. Using this Act as an important vehicle for improving the health care decisionmaking process, Lawrence P. Ulrich explains the social, legal, and ethical background to the Act by focusing on well-known cases such as those of Karen Quinlan and Nancy Cruzan, and he explores ways in which physicians and other caregivers can help patients face the complex issues in contemporary health care practices. According to Ulrich, health care facilities often address the letter of the law in a merely perfunctory way, even though the Act integrates all the major ethical issues in health care today. Ulrich argues that well-designed conversations between clinicians and patients or their surrogates will not only assist in preserving patient dignity — which is at the heart of the Act—but will also help institutions to manage the liability issues that the Act may have introduced. He particularly emphasizes developing effective advance directives. Ulrich examines related issues, such as the negative effect of managed care on patient self-determination, and concludes with a seldom-discussed issue: the importance of being a responsible patient. Showing how the Patient Self-Determination Act can be a linchpin of more meaningful and effective communication between patient and caregiver, this book provides concrete guidance to health care professionals, medical ethicists, and patient-rights advocates.


Advance Directives

Advance Directives

Author: Peter Lack

Publisher: Springer Science & Business Media

Published: 2013-10-21

Total Pages: 214

ISBN-13: 9400773773

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This volume gives an overview on the currently debated ethical issues regarding advance directives from an international perspective. It focuses on a wider understanding of the known and widely accepted concept of patient self-determination for future situations. Although advance directives have been widely discussed since the 1980s, the ethical bases of advance directives still remain a matter of heated debates. The book aims to contribute to these controversial debates by integrating fundamental ethical issues on advance directives with practical matters of their implementation. Cultural, national and professional differences in how advance directives are understood by health care professions and by patients, as well as in laws and regulations, are pinpointed.


Advance Directives in Mental Health

Advance Directives in Mental Health

Author: Jacqueline M Atkinson

Publisher: Jessica Kingsley Publishers

Published: 2007

Total Pages: 217

ISBN-13: 1843104830

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A comprehensive and accessible guide for mental health professionals advising service users on their choices about treatment in the event of future episodes of mental illness, covering all ideological, legal and medical aspects of advance directives.


Taking Persons Seriously

Taking Persons Seriously

Author: Mihretu P. Guta

Publisher: Wipf and Stock Publishers

Published: 2024-06-06

Total Pages: 340

ISBN-13: 1666796468

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This volume attempts to show why ontology matters for a proper grasp of issues in bioethics. Contemporary discussions on bioethics often focus on seeking solutions for a wide range of issues that revolve around persons. The issues in question are multi-layered, involving such diverse aspects as the metaphysical/ontological, personal, medical, moral, legal, cultural, social, political, religious, and environmental. In navigating through such a complex web of issues, it has been said that the central problems philosophers and bioethicists face are ethical in nature. In this regard, biomedical sciences and technological breakthroughs take a leading role in terms of shaping the sorts of questions that give rise to ethical problems. For example, is it ethical to keep terminally ill patients alive on dialysis machines or artificial ventilators? Is it ethical to take someone's vital organs upon death and transplant them into another person's body without any prior consent from the deceased person? Reproductive techniques also raise complicated ethical issues involving in vitro fertilization, contraceptives, prenatal testing, abortions, and genetic enhancements. Moreover, biomedical issues raise ethical problems regarding research on human subjects, stem cell research, and enhancement biotechnology. The beginning and end of life issues bring up their own complicated ethical conundrums involving, among other things, terminating life support and euthanasia. This book approaches such complex bioethical questions by engaging in ground-level debates about the ontology of persons. This is a nonnegotiable first step in taking steps forward in seeking a plausible solution(s) for the complex ethical problems in bioethics.


Self-Determination, Dignity and End-of-Life Care

Self-Determination, Dignity and End-of-Life Care

Author: Stefania Negri

Publisher: Martinus Nijhoff Publishers

Published: 2012-02-03

Total Pages: 488

ISBN-13: 9004223576

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By providing an interdisciplinary reading of advance directives regulation in international, European and domestic law, this book offers new insights into the most controversial legal issues surrounding the debate over dignity and autonomy at the end of life.


Approaching Death

Approaching Death

Author: Committee on Care at the End of Life

Publisher: National Academies Press

Published: 1997-10-30

Total Pages: 457

ISBN-13: 0309518253

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When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."