End of Life Care
As a nurse and a professional in the health field, we know that end-of-life care is not only for the patients that are in the final days of their lives, but also for the care of all those with a terminal illness or terminal condition that has become advanced, progressive and incurable. Some of the important aspects of end of life care that have to be considered and talked about are autonomy of the patient, decision making capacity, informed consent and advance directives.
Autonomy
In our book Ethics and issues in contemporary nursing, autonomy is defined as an ethical principle that literally means self-governing. It denotes having the freedom to make independent choices (Burkhardt & Nathaniel, 2014, p. 525). In healthcare, …show more content…
This is best stated in the World Health Organization report on palliative care and older people, which states that “however complex a person’s problems or uncertain their future may be, autonomy is a key human right and maintaining this must be a core ethical value for society and health services’. Patient choice is heavily promoted in the NHS end-of-life strategy for England: promoting high quality of care for all adults at end-of-life (Wilson, Ingleston, Gott, & Gardiner, 2014, p. …show more content…
In most states, the order of preference for surrogates is spelled out in some fashion in the mental health codes. Depending on the clinical setting, finding a surrogate can be done by the clinician, a hospital or agency social worker, or a case manager. Once the surrogate agrees, their name, address and relationship to patient should be documented in medical record along with information determining capacity (Carroll, 2010, p. 51). The surrogate is held to a standard and must follow two concepts: Best interest and substituted judgment. One is based on case law and a test called “best interests”. The courts will decide who will be surrogate if the patient has no family or no one appointed. Furthermore, this process can be lengthy so the present situation is considered but emergent care is allowed without surrogate and with patient lacking capacity (Carroll, 2010, p.
As a nurse and a professional in the health field, we know that end-of-life care is not only for the patients that are in the final days of their lives, but also for the care of all those with a terminal illness or terminal condition that has become advanced, progressive and incurable. Some of the important aspects of end of life care that have to be considered and talked about are autonomy of the patient, decision making capacity, informed consent and advance directives.
Autonomy
In our book Ethics and issues in contemporary nursing, autonomy is defined as an ethical principle that literally means self-governing. It denotes having the freedom to make independent choices (Burkhardt & Nathaniel, 2014, p. 525). In healthcare, …show more content…
This is best stated in the World Health Organization report on palliative care and older people, which states that “however complex a person’s problems or uncertain their future may be, autonomy is a key human right and maintaining this must be a core ethical value for society and health services’. Patient choice is heavily promoted in the NHS end-of-life strategy for England: promoting high quality of care for all adults at end-of-life (Wilson, Ingleston, Gott, & Gardiner, 2014, p. …show more content…
In most states, the order of preference for surrogates is spelled out in some fashion in the mental health codes. Depending on the clinical setting, finding a surrogate can be done by the clinician, a hospital or agency social worker, or a case manager. Once the surrogate agrees, their name, address and relationship to patient should be documented in medical record along with information determining capacity (Carroll, 2010, p. 51). The surrogate is held to a standard and must follow two concepts: Best interest and substituted judgment. One is based on case law and a test called “best interests”. The courts will decide who will be surrogate if the patient has no family or no one appointed. Furthermore, this process can be lengthy so the present situation is considered but emergent care is allowed without surrogate and with patient lacking capacity (Carroll, 2010, p.