Nurses and Advanced Directives

Paper Summary:

This paper outlines a strategy for teaching the approach of advanced directives conversations to a group of nurses in long-term care. The paper maintains that terminally ill people, elderly and those who are currently living through their end of life are within their rights to have a better, more comprehensive and caring system to help them make and uphold their decisions about end-of-life care.

Outline:
Introduction
Part A Research Base
Presentation Plan
Conclusion

From the Paper:

"The older document, titled the living will is important but does not always demonstrate the whole scope of medical care that might be offered an individual if he or she is faced with a specific medical care decision and may need to be amended to include the determination of a proxy for the individual, before such time as one is needed. (Burnell, 1993, p. 219) As such stand alone Advanced Directive documents tend to be more reflective of patient rights (Galambos, 1998, p. 275) as well as very specific medical treatment plans that the patient might opt into or out of given his or her current state of health and his or her personal beliefs and or desires regarding end of life. (Mcnamara, 2001, p. 19) (Shannon & Walter, 2005, p. 651) (Hardwig, 2000, p. 28) Recent legal decisions as well as universal and institutional protocols have stressed individual rights for end of life decision making, yet there are significant issues with cognitive impaired patients, often suffering from deteriorating diseases making decisions, at different stages of disease process. (Kunkel & Wellin, 2006, p. 6) (Lacey, 2006, p. 189)"

Sample of Sources Used:

• Burnell, G. M. (1993). Final Choices: To Live or to Die in an Age of Medical Technology. New York: Insight Books.
• Fisher, C. B. (2002). A Goodness-of-Fit Ethic for Informed Consent. Fordham Urban Law Journal, 30(1), 159.
• Galambos, C. M. (1998). Preserving End-of-Life Autonomy: The Patient Self-Determination Act and the Uniform Health Care Decisions Act. Health and Social Work, 23(4), 275.
• Hardwig, J. (2000). Spiritual Issues at the End of Life: A Call for Discussion. The Hastings Center Report, 30(2), 28.
• Hawkins, A. H., Ballard, J. O., & Blaisdell, T. (Eds.). (1995). Time to Go: Three Plays on Death and Dying, with Commentary on End-of-Life Issues. Philadelphia: University of Pennsylvania Press.

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