Life-Sustaining Treatment under Dispute

2020 ◽  
Vol 20 (4) ◽  
pp. 667-682
Author(s):  
Jackson Milton ◽  
Keyword(s):  
Advance Directives ◽  
Patient Harm ◽  
Life Sustaining Treatment ◽  
Texas Advance Directives Act

The Texas Advance Directives Act stipulates the process by which physicians may withhold or withdraw life-sustaining treatment contrary to the wishes of the patient or medical proxy. Hundreds, perhaps thousands of families and clinicians have faced this personal and distressing dispute. Catholic teaching offers a rich tradition for assessing the ethics of life-sustaining treatment and analyzing disputes over its administration, yielding the conclusion that a Catholic defense of the Texas Advance Directives Act is untenable. Two objections rooted in patient harm and physician conscience fail. A solution that fairly respects the patient’s moral right to choose life-sustaining treatment is offered.

scholarly journals Texas Advance Directives Act: Nearly a Model Dispute Resolution Mechanism for Intractable Medical Futility Conflicts

2016 ◽  
Vol 16 (1) ◽  
pp. 22 ◽  
Author(s):  
Thaddeus Mason Pope
Keyword(s):  
Dispute Resolution ◽  
Advance Directives ◽  
Due Process ◽  
Medical Futility ◽  
The United States ◽  
Life And Death ◽  
Procedural Due Process ◽  
The World ◽  
Dispute Resolution Mechanism ◽  
Texas Advance Directives Act

<em>Increasingly, clinicians and commentators have been calling for the establishment of special adjudicatory dispute resolution mechanisms to resolve intractable medical futility disputes. As a leading model to follow, policymakers both around the United States and around the world have been looking to the conflict resolution provisions in the 1999 Texas Advance Directives Act (‘TADA’). In this article, I provide a complete and thorough review of the purpose, history, and operation of TADA. I conclude that TADA is a commendable attempt to balance the competing goals of efficiency and fairness in the resolution of these time-sensitive life-and-death conflicts. But TADA is too lopsided. It is far more efficient than it is fair. TADA should be amended to better comport with fundamental notions of procedural due process.</em>

Requests for Nonbeneficial Treatment (DRAFT)

2018 ◽  
Author(s):  
Robert C. Macauley
Keyword(s):  
Health Care ◽  
Advance Directives ◽  
Health Care Costs ◽  
Consensus Statement ◽  
Right To Die ◽  
The Right ◽  
Texas Advance Directives Act ◽  
Care Costs

The 1990s were termed the “futility decade” because of greater interest in cases where the patient demands treatment that the physician is reluctant to provide. In many ways this was the converse of the “right to die” movement of the 1970s and 1980s, except it did not lead to resolution because of definitional and practical barriers. The concept of nonbeneficial treatment—a more acceptable term—has recently received additional attention in the context of soaring health care costs. Some states have proposed clear and definitive mechanisms for adjudicating such disputes (such as the Texas Advance Directives Act). Each institution should have its own policy that can be modeled after a recent consensus statement on the topic.

scholarly journals KNOWLEDGE OF END-OF-LIFE CARE, LIFE-SUSTAINING TREATMENT, AND ADVANCE DIRECTIVES IN NURSING STUDENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S727-S727
Author(s):  
Jooyoung Cheon
Keyword(s):  
Nursing Students ◽  
End Of Life ◽  
Advance Directives ◽  
Critical Role ◽  
Cross Sectional ◽  
Clinical Practicum ◽  
Undergraduate Nursing ◽  
Dying Patients ◽  
Life Sustaining Treatment ◽  
Eol Care

Abstract Knowledge of end-of-life (EOL) care and being able to make the appropriate decisions for patients who are dying is important for nursing students, who will soon play a critical role in EOL decision-making among patients and their caregivers. Accordingly, the purpose of this study was to examine the level of knowledge of EOL care, life-sustaining treatment, and advance directives among nursing students in South Korea. This cross-sectional descriptive study was conducted from December 2017 to February 2018. Data were collected from 220 undergraduate nursing students and analyzed using descriptive statistics, t-tests, one-way ANOVA, and a post hoc test with the SPSS 19.0 program. The score for knowledge of EOL care was 7.8 out of 11 points, for knowledge of life-sustaining treatment was 4.6 out of 6 points, and for knowledge of advance directives was 7.0 out of 9 points. There were significant differences in knowledge of EOL care scores by year of study, experiences in clinical practicum education, and experiences of caring for dying patients. Knowledge of life-sustaining treatment significantly differed by year of study, experiences in clinical practicum education, experiences of caring for and observing dying patients during clinical practicum education, and perceived self-rated health. There were significant differences in knowledge of advance directive scores by year of study, satisfaction with nursing major, experiences in clinical practicum education, and experiences of caring for and observing dying patients during clinical practicum education. Further studies should develop educational intervention programs that improve knowledge of EOL care, life-sustaining treatment, and advance directives.

On the Edge of Death—To Intervene or Not

2020 ◽  
pp. 33-40
Author(s):  
Alexander Zoretich ◽  
Arvind Venkat
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Advance Directives ◽  
Medical Condition ◽  
Living Will ◽  
Ethical Challenges ◽  
Power Of Attorney ◽  
Medical Decisions ◽  
Life Sustaining Treatment ◽  
End Stage

Advance directives and actionable medical orders are documents that convey a patient’s wishes regarding medical treatment. Common advance directives are living will and health care power-of-attorney documents. Living wills state what a patient wants if not able to communicate for themselves and having an end-stage medical condition or permanent unconsciousness. Health care powers of attorney state whom a patient would want to make medical decisions on their behalf if not able to communicate for themselves. Both of these documents have minimal application in the emergency department given the time constraints of care in this setting. Actionable medical orders, such as Physician Orders for Life-Sustaining Treatment (POLSTs), have immediate application in the emergency department but carry their own challenges in interpretation by emergency physicians. This chapter reviews the nature of advance directives and actionable medical orders and the legal and ethical challenges posed by their application in the emergency department.

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