Final Exam: Living Wills

Questions to discuss later in the dying [process

-Is the patient as comfortable and as pain free as possible -how is the mental state of the patient -does the patient feel as in control as possible

The Attending Physicians fail to comply with them

-due to "conflict of interest" -due to religious/philosophical conflicts -due to ignorance

Living Will

A legal document listing what the patient wishes for medical care should she/he not be able to speak for herself/himself.

(Medical/Durable) Power of Attorney

A legal document used by the patient to appoint someone to express on their behalf what they would want regarding health care, should she/he not be able to speak for herself/himself

Comfort Care

Includes all medical procedures, and such life support measures as artificial respiration, nutrition, and hydration, that increase the comfort of the patient, but which may not have any therapeutic value.

Life Support

Medical procedures and other non-self-administered measures (like nutrition, hydration) that prolong the life of a terminal patient.

Palliative Care

Medical procedures given to a dying patient that has no therapeutic value

Terminal Condition

An irreversible, untreatable condition caused by disease, illness or injury, determined to a reasonable degree of certain by at least 2 physicians to be both incurable and likely to cause death in a short time if life sustaining measures are not administered.

Patients Rights

-Be fully involved in decisions about end-of-life care -Refuse any unwanted medical treatment, for any reason, even if the refusal should lead to death -Withdraw any unwanted medical treatment -Refuse any form of nutrition or hydration -Refuse Cardiopulmonary Resuscitation (CPR) -Have a living Will or Advance Directive followed -Have his/her pain and suffering relieved, even if death is the unintended result. -Ask for a referral to hospice care -Ask a doctor to assist in ending his or her life -Request terminal sedation -Change doctors

Important Questions to Discuss Early in Dying Process

-Does the patient have a living will and/ or power of attorney for health care -Does the patient have a will for estate -Are there any special wishes for funeral -What would the patient like done with his/her body -What special comfort needs are there -Are there people the patient would like sp especially see?

Problems with Living Wills

-The attending physician fails to comply with them -The patient changes his or her mind about what he or she want -The power of attorney fails to carry out the patient's wishes -The living will is lost, the patient is incompetent, and there is no power of attorney

The patient changes their mind about what they want

-due to fear of dying -due to lack of family support or family pressure -due to lack of competency

The living will is lost, the patient is incompetent, and there is no power of attorney

-in which case the physicians are obliged to provide life sustaining measures

Advance Directives

A set of legal documents that describe a patient's wishes should he/she not be able to speak for himself/herself, among which: -Living Will -(Medical/Durable) Power of Attorney -Comfort Care -Palliative Care -Life Support -Terminal Condition