Consult your physician or care-administrator for the best service for you. Reprinted with permission. For additional caregiving information, visit www.
Find Advance Directives in your state. Courtesy of:. Moore All Rights Reserved. Palliative Care - Article. Caregivers Resources. Hospice Vs. Palliative Care.
The differences between hospice and palliative care. Funeral Planning. Grief and Loss. Hospice and more Advance Directives. At a minimum, our heightened awareness and willingness to talk about illness, dying, caregiving and grieving will lead to much better end-of-life care. Like individuals who grow wiser with age, collectively, in turning toward death, we stand to learn a lot about living. Doctors can be valuable guides in this process. In matters of illness, people are fascinated by the question, what would doctors do?
Consider the social phenomenon of Dr. Murray wrote that doctors he knew tended to die differently than most people, often eschewing the same late-stage treatments they prescribed for patients. The article went viral, being read by millions, and reprinted in multiple languages in magazines, newspapers and websites across the globe. So far, results are mixed.
In a Stanford study , 88 percent of responding physicians said they would avoid invasive procedures and life-prolonging machines. But a newly released comparative study of Medicare recipients , as well as a longitudinal study and separate analysis of Medicare data published in January, suggest that the actual differences between end-of-life treatments that doctors and nondoctors receive are slight.
Perhaps like nearly everyone else, when life is fleeting, physicians find it difficult to follow their previous wishes to avoid aggressive life-prolonging treatments. More to the point is the question, how do dying doctors live? What dying doctors do with their time and limited energy, and what they say, are deeply personal, sometimes raw and often tender. Like everyone else, doctors experience pain and suffering — yet many speak of a deepening moment-to-moment sense of life and connection to the people who matter most.
Jane Poulson lost her sight to diabetes while still in medical school. After years of successful internal medicine practice, Dr. Poulson developed inflammatory breast cancer and knew it would claim her life. The information about proper implications and use of advance directives can facilitate in understanding and addressing legal issues arising from planning ahead by the patient or by the primary care givers [ 4 ]. The technological advancements and innovations are reshaping the decisions and treatment preferences surrounding end-of-life care. These technologically advanced treatments have a capability to prolong the life of a patient rather than allowing the natural dying process.
The end-of-life decisions to sustain life are considered on the basis of patient centered care, quality of life after these advance treatments and have to be weighed along with shared decision-making process [ 1 ]. These new medical treatments and technologies are increasing the number of people seeking long-term care.
It is challenging to provide long-term advanced treatment and care to the population considering the increase in older population and assessing the projected increase in this population, especially when the baby boom a cohort born between — reach old age by [ 4 ]. It is assumed that people will adapt to healthy lifestyles and thus, this will reduce disabilities, diseases and injuries. This advancement will lower death rate and increase people living longer and needing long term care in their later life [ 4 ].
People should understand that they are mortals and consider getting information and making plans for end-of-life care preferences [ 7 ]. The futile and expensive treatment at end-of-life situations are increasing the unaffordable cost of healthcare and promoting inequitable healthcare. The ethical value of patient autonomy and surrogate autonomy should be respected but weighed against the use of expensive treatment in futile case circumstances with current increase in healthcare costs. Hence, in case of futile treatments, families and patients can ethically consider the option for comfort care.
The advanced technologies hold no promises for recovery. These treatments can also lead to few humiliating and undignified situations for the patients which can be emotionally burdensome.
Healthcare rationing of end-of-life care in futile situations can be considered as greatest good for society but has to be weighed against the patient autonomy [ 8 ]. It is difficult for the general population seeking medical care to understand the concept of limited treatment in case of futile cases.
The stewardship of limiting medical care is surrounded by ethical issues as the patients and their families do not understand the need to limit treatment in some cases where it is futile. Healthcare providers and physician are working towards this challenging task of making patients understand the need to refuse treatment as it may not benefit them and in some cases can cause harm. There are no strict criteria to differentiate futile treatment; hence it has to be relied on expert judgment and case prognosis.
Considering the aspect of access of quality care to the people who need them most, the rationing of care in futile situation can be justified. Rationing of care is present in the current healthcare system and can be justified as equitable justice if carried out ethically and equitably [ 9 ]. Medical resource allocation is often limited and hence has to be distributed equitably. There is a need for evaluating and assessing the medically advanced treatment so as to avoid any undue use of already limited resources. This can be achieved by good education, knowledge about advanced treatment implications and improved healthcare decision making from patients, their families and physicians [ 7 ].
The expenditure on healthcare is too much in relation with total number of people and outcome. United States is spending a lot of money on health care and the average dollar amount per person is also much higher. Having said that, the health care expenditure is increasing, and at the same time people are spending more on getting the care they need.
Free Essay: END OF LIFE ISSUE- YOU DECIDE With major advancement in medical treatments, it is now possible to keep a patient alive. Free Essays from Bartleby | Introduction Bringing end-of-life care back into the The issues around death and end of life care are not discussed openly (Ho.
The cost of producing health care services due to advancement and innovations in technology is increasing the expenditure involved in providing these healthcare advanced treatment services. These healthcare services should not only target lengthening the life of people but also improve the quality of life [ 10 ], especially when end-of-life decisions and the costs involved in it are concerned. The medical treatments are financially burdensome to some patients; hence easy accessibility to quality care at affordable cost can lessen the financial issue adherent to the end-of-life care considering the increase in the unaffordability of healthcare [ 9 ].
They have to work against the egoistic theory by working for the good of the patient [ 4 ]. While carrying out this act of beneficence, the physician has to provide information about the treatment, especially in case of futile treatment so as to avoid any undue harm to the patient. In case of futile treatments, healthcare providers also have to consider the allocation of limited resources available to manage the case scenario so as to avoid inequity.
Hence, healthcare providers also have to consider the aspect of equitable and distributive justice in cases where expensive treatment provided to the patient during end-of-life situation may be futile, and utilize lot of resources, leading to unequal distribution of limited medical and technological resources [ 4 ]. Additionally, they have to address the issues of unnecessary and unequal distribution of resources by withdrawing or withholding the futile treatment [ 5 ].
The task of healthcare executives to manage ethical issues surrounding end-of-life care is challenging.
Healthcare executives can address these ethical dilemmas ensuring certain policies to be followed during managing this task. They can guide the patients and their surrogates to make informed treatment preferences by providing them trustful information, appropriate prognosis and available options regarding the case specific treatment choices. They can assist the patient and their families to make a well judged end-of-life care decision and document their preferences. In case there is a disagreement between the healthcare provider and the patient or surrogate end-of-life care choices, then they can take appropriate steps by appointing an ethics committee to address this ethical or legal issue and document its proceedings.
Healthcare executives can compile policies, so as to introduce, promote, and discuss the use of advanced directives as an admission procedure [ 1 ]. This can motivate the patients to make a living will advanced directive about their end-of-life care preferences which in due process can facilitate families to make appropriate decisions in case of incapacitated patients.
There should be a proper disclosure mentioning the limitations of certain specific treatment options if there are any, so that the patients and families are well informed about their treatment options and make well-judged decisions.