Legal and Ethical Issues in Aging Flashcards
(37 cards)
Define competence
A legal term, indicates an individual has ability to understand the nature and consequences pf decisions
Define Capacity
Ability to make a specific decision
Define Informed Consent
Only possible due to presumption adults are competent.
To have the capacity to make a decision, the patient mush have what three things?
- Be able to understand relevant info and the implication of various treatment choices
- Reflect on information in accordance with personal values and draw conclusions
- Make and communicate a choice to healthcare professionals
If there is no advanced directive, how can decisions be made for an individual?
Decisions may be made based off of what the patient has previously stated.
Legal competency and capacity to make healthcare decisions are determined by whom?
The court, but it can be quite lengthy
Ethics committees may serve as what?
More practical intermediaries than going all the way to court
What is the goal of informed consent?
To promote patient autonomy
What does informed consent generally include?
What a reasonable patient would want to know or a reasonable healthcare provider should discuss.
What is usually discussed during an informed consent meeting?
The patients diagnosis, risks and benefits of the proposed procedure, alternative treatments that may be available, risks and benefits of forgoing proposed treatment.
What does POLST stand for?
Physician Orders for Life Sustaining Treatment
What is an advanced directive?
Morally and in some jurisdictions legally binding document that adults can express their wishes regarding end of life decisions for a future time when they are unable to do so for themselves.
What are two common forms of Advanced directives?
Living wills, and durable power of attorney for heath care
Why were advanced directives developed?
In response to concern patients were being forced to undergo unwanted, futile, uncomfortable, or degrading treatments to preserve life at all costs against patients wishes.
What is the patient self-determination act?
Requires healthcare facilities to inform patients about right to complete an advance directive
What are the components of a durable power of attorney?
individual appoints someone to make their health decisions if he or she looses the ability to do so, is effective any time the patient has temporary/permanent absence of decisional capacity. Proxy has legal authority to interpret wishes based on medical circumstances.
What are the components of a Living will?
Prospective declaration, outlines wishes for those with no one to appoint as a proxy, can also provide guidance for DPAHC about treatment preferences and EOL care and wishes. Effective only at end of life.
Define DPAHC
Durable power of attorney for health care.
Is a DPAHC restricted to specific situations?
No, It is not restricted and can make decisions as need arises not limited to situations thought of previously.
Is a Living will restricted to specific situations?
Yes, it provides specific instructions about treatments and interventions that the individual would or would not want in specific circumstances. Its usefulness is limited because the circumstances have to be though of before hand.
What is the goal of a DNR/DNI?
To support patient autonomy and prevent non-beneficial interventions
What is the survival rate of field CPR?
10 - 15 %
What are DNR protocols based on?
Three value considerations
What are the three value considerations that a DNR is based on?
self-determination, well-being, and equity
