Despelder8_ppt_ch06

Despelder8_ppt_ch06 - Chapter SixC Chapter • End of Life...

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Unformatted text preview: Chapter SixC Chapter • End of Life Issues and Decisions Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Fundamental Ethical Principles s s s Autonomy Beneficence Justice Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Informed Consent to Treatment s s s Competency Freely given Adequate understanding Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Evolution of Informed Consent s s Early 1960s: strong tendency to Early withhold information withhold Late 1970s: strong tendency to Late disclose information disclose Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright SUPPORT (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment) s s Multicenter study to assess end of life Multicenter care care Fewer than half of physicians aware Fewer of patient preferences for or against CPR CPR Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Medical Orders s s s “DNR” -- Do not resuscitate “No code” -- No cardiopulmonary No resuscitation (CPR) resuscitation “CMO” -- Comfort measures only Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Choosing Death: The Right To Die s s Withholding or withdrawing Withholding unwanted or futile treatments unwanted Distinction between “allowing to die” Distinction and “helping to die” and Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Landmark Judicial Decisions s s s 1975: Karen Ann Quinlan (artificial 1975: respiration) respiration) 1990: Nancy Beth Cruzan (feeding 1990: tube) tube) 2006: Terry Schiavo (feeding tube) Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Aspects of the Schiavo Case s s s 1998-2003 court struggle between 1998-2003 Terri Schiavo’s husband and her parents parents “Terri’s Law” initiated by Florida Terri’s legislature legislature The importance of legal advance The directives directives Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Intentionally Hastening Death of a Person s s Physician-assisted suicide (PAS) Active euthanasia Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Physician-Assisted Suicide: USA s 1997, the U.S. Supreme Court ruled 1997, that the right to refuse treatment is refuse based on a right to maintain one’s bodily integrity, not on a right to hasten death hasten Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Physician-Assisted Suicide: USA (continued) s s Supreme Court also affirmed that Supreme states can draft policy concerning physician-assisted suicide physician-assisted Currently, Oregon is the only U.S. Currently, state where physician-assisted suicide is legally permitted is Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright The Concept of “Double Effect” s s s An intended “good effect” can have a An potential “bad effect” potential Medication to relieve pain may be Medication given to a patient even though a dose that is sufficient to relieve pain also hastens the patient’s death hastens This practice is sometimes termed This “terminal sedation” “terminal Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Measures to Add Dignity to the Dying Process s s s s Greater use of hospice and palliative Greater care care More aggressive pain management Timely diagnosis of a terminal illness Make right to refuse treatment Make universally available to patients universally Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Measures to Add Dignity to the Dying Process (continued) s s s Expand use of DNR orders to avoid Expand unnecessary care unnecessary Provide universal access to Provide appropriate combination of care options (home, hospice, etc.) options Institute health insurance system that Institute ensures adequate and appropriate care for everyone for Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Advance Directives : Living Will s Living will provides instructions Living about the kind of medical care you wish to receive if you become unable to participate in treatment decisions to Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Advance Directives : Health Care Proxy s Health care proxy appoints a surrogate Health to make decisions about medical treatment if you become unable to do so. so. Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Wills and Inheritance s A will is a legal declaration will expressing a person’s intentions and wishes for the disposition of his or her estate -- money, property, and other possessions -- after death possessions Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Wills and Inheritance (continued) s The issues and legalities associated The with wills and inheritance can have either a beneficial or an adverse effect on survivors on Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Wills and Inheritance (continued) s Estate planning can help ensure peace Estate of mind for both the bereaved and the person putting his or her affairs in order. order. Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Insurance and Death Benefits s s Psychological and emotional value Viatical settlement Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Considering Ethical Issues s s s Analysis and theory versus “morality Analysis of ordinary practice” and “what genuinely moves people to act” genuinely Ethical choices involve both personal Ethical and cultural values and Every human encounter is an ethical Every encounter encounter Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright ...
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This note was uploaded on 03/02/2011 for the course SOC 353 taught by Professor Ibrahimnaim during the Spring '11 term at ASU.

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