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Difference between revisions of "Substitute Decision Making for Adult Guardianship (15:IV)"
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Substitute Decision Making for Adult Guardianship (15:IV) (view source)
Revision as of 00:35, 11 October 2022
, 00:35, 11 October 2022→4. Examples of Advance Directive Provisions
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Examples of directives made in an AD might include consenting or refusing consent to the following: | Examples of directives made in an AD might include consenting or refusing consent to the following: | ||
* CPR (if cardiac or respiratory arrest occurs) | |||
* Artificial nutrition through intravenous or tube feedings | |||
* Prolonged maintenance on a respirator (if unable to breathe adequately alone) | |||
* Blood cultures, spinal fluid evaluations, and other diagnostic tests | |||
* Blood transfusions | |||
Note that it is not likely that simple refusals like ‘I refuse CPR’ are going to be sufficient for health care providers. It is important to describe the circumstances to the best degree possible under which consent will be refused, such as only refusing CPR if cardiac arrest occurs, rather than stating only to refuse CPR. The adult may use the phrase ‘under any circumstances’ to make it clear to health care professionals that consent is not given in any case. | Note that it is not likely that simple refusals like ‘I refuse CPR’ are going to be sufficient for health care providers. It is important to describe the circumstances to the best degree possible under which consent will be refused, such as only refusing CPR if cardiac arrest occurs, rather than stating only to refuse CPR. The adult may use the phrase ‘under any circumstances’ to make it clear to health care professionals that consent is not given in any case. | ||
:'''NOTE:''' The adult should have their AD added to their doctor’s patient files, their hospital records, and any other relevant agencies. If the AD is revoked or altered, the adult should advise each of these agencies or provide them with the new or revised AD. | |||
===== a) Do Not Resuscitate Orders ('DNR Orders') ===== | ===== a) Do Not Resuscitate Orders ('DNR Orders') ===== | ||
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• A competent person has the right to refuse, or withdraw consent to, any clinically indicated treatment, including life-saving or life-sustaining treatment (Principle 3). In this situation, the healthcare professional will discuss with the patient whether the patient wishes to be resuscitated and a notation will be made on the person’s chart.<br> | • A competent person has the right to refuse, or withdraw consent to, any clinically indicated treatment, including life-saving or life-sustaining treatment (Principle 3). In this situation, the healthcare professional will discuss with the patient whether the patient wishes to be resuscitated and a notation will be made on the person’s chart.<br> | ||
• When a person is incompetent, treatment decisions must be based on their wishes, if these are known. The person's decision may be found in an advance directive or may have been communicated to the physician, other members of the health care team or other relevant people. In some jurisdictions, legislation specifically addresses the issue of decision-making concerning medical treatment for incompetent people; the legislative requirements should be followed (Principle 4). | • When a person is incompetent, treatment decisions must be based on their wishes, if these are known. The person's decision may be found in an advance directive or may have been communicated to the physician, other members of the health care team or other relevant people. In some jurisdictions, legislation specifically addresses the issue of decision-making concerning medical treatment for incompetent people; the legislative requirements should be followed (Principle 4). | ||
==== 5. Note on ADs for LSLAP Students ==== | ==== 5. Note on ADs for LSLAP Students ==== | ||