Law or Compliance Standard ethical standards

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Course Learning Outcomes for Unit VII Upon completion of this unit, students should be able to:

3. Classify current compliance standards related to health information initiatives. 3.1 Discuss recommendations for protecting health information.

4. Identify ethical standards of professional practice in healthcare settings.

4.1 Describe scenarios where a law/compliance standard must be applied.

6. Explain the importance of patient rights including advance directives. 6.1 Explain how advance directives apply in workplace scenarios.

Course/Unit Learning Outcomes

Learning Activity

3.1

Unit Lesson Chapter 11, pp. 279–296 Chapter 12, pp. 308–331 Unit VII Research Paper

4.1

Unit Lesson Chapter 11, pp. 279–296 Chapter 12, pp. 308–331 Unit VII Research Paper

6.1

Unit Lesson Chapter 11, pp. 279–296 Chapter 12, pp. 308–331 Unit VII Research Paper

Required Unit Resources Chapter 11: The Beginning of Life and Childhood, pp. 279–296 Chapter 12: Death and Dying, pp. 308–331

Unit Lesson Understanding Advance Directives It is very important for all healthcare professionals to understand advance directives. These documents play a crucial role in the end-of-life decision process in every U.S. hospital, every long-term care facility, and every hospice. In this lesson, you will learn about living wills and healthcare proxies (durable power of attorney for health care). Also considered will be the aspects of hospice and palliative care as they relate to patients. Advance directive is a generic term that refers to any document that a patient completes to give instructions to caregivers about his or her own health care (Judson & Harrison, 2019). Advance directives are also used to appoint someone—a family member, friend, or other person—to make medical decisions for the patient when he or she cannot make such decisions. Certainly, the living will and the durable power of attorney for health care are the two most commonly used advance directive documents in the United States.

UNIT VII STUDY GUIDE

Health Care Throughout the Lifespan

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Hospital Requirement Prior to admitting any patient, hospitals are required by law to ask if he or she has an advance directive. If so, then a copy of the advance directive is obtained and made a permanent part of the patient’s medical record. If the patient does not have an advance directive, the hospital representative is required by law to ask if he or she would like to have someone talk to them about putting such a document in place. All advance directives must be signed by the patient and witnessed. Many patients are under the mistaken impression that a lawyer is needed to create a living will or that a fee is required; that is completely untrue. The appropriate forms for any patient to create an advance directive are available free online at the link below and are available for every U.S. state. National Hospice and Palliative Care Organization. (n.d.). Home page. Retrieved from

https://www.nhpco.org/patients-and-caregivers/ There are some significant differences in the laws regarding advance directives from state to state, so it is important for the patient to use the form specifically prepared for his or her own state. Once the advance directive is created, it is wise to give a copy to the patient’s physician, lawyer, hospital, and a few key family members. Living Will The living will is probably the advance directive that most have heard of and the one most have actually completed for themselves. The living will is a document in which you state your wishes about life-sustaining medical treatment if you are terminally ill, permanently unconscious, or in the end-stage of a fatal illness (Judson & Harrison, 2019). Living wills do not have to reflect all or nothing decisions. For example, a patient might decide that he or she does want medications, IV fluids, comfort care, and nutrition in such a situation but does not want to receive CPR or be intubated and placed on a ventilator. That combination is commonly seen in elderly persons who have experienced longstanding chronic illness. Another patient might want no life support efforts made at all. Another patient might want every possible resource to be used for resuscitation and continuation of life. The point is only the patient can truly decide in these matters. The living will shares with caregivers the patient’s preferences at a crucial time when the patient often cannot express those wishes for him or herself. Durable Power of Attorney for Health Care (or Proxy) This is a document in which the patient appoints someone else to make medical treatment decisions for him or her when he or she cannot make such decisions personally. The person named to do so is called an agent, proxy, representative, or surrogate. One can also include specific instructions for decision-making and mention other persons who should be consulted in the decision-making (Judson & Harrison, 2019). The durable power of attorney for health care appoints a captain of the ship for very important end-of-life decisions. In fact, some patients trust their proxy so strongly that they decide not to have a living will and only have a proxy. Sometimes, the proxy is a family member but not always. Some patients feel that they want such difficult end-of-life decisions made by someone who has no financial connection to the decision. In that case, the proxy selected might be a close friend, a pastor, or the family attorney. Hospice Care Dying patients may choose hospice care rather than continuing with traditional hospital medical care. For admission to hospice, the patient’s physician must specify that in his or her opinion the patient has less than six months to live. That does not mean, however, that hospice care will suddenly end if the patient lives more than six months. The six-month timeframe is just an estimate, and some hospice patients wind up receiving care for a year or longer (Judson & Harrison, 2019). Hospice care can be done in a hospital setting, in a nursing home setting, or in the patient’s home. Many patients chose the home setting. Hospice can be thought of as a holistic and philosophical approach to the end of life. It brings doctors, nurses, respiratory therapists, social workers, and other professionals together as a care team focusing not on treatment for recovery but on the patient’s comfort. The hospice team’s goal is to make the patient as comfortable as possible during his or her final days, weeks, or months. Key objectives include pain control, symptom management such as nausea, natural death, and quality of life for as long as possible. In addition to the professional staff, hospice provides volunteers to help in the home. They do simple things such as shopping

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for groceries, mowing the lawn, and cleaning. Volunteers also will sit with the patient so that the spouse can get away for a short time and recover from the stress of the situation. Hospice is truly a wonderful program for many families. Palliative Care Palliative care is similar to hospice. Palliative care works to achieve one of the primary goals of any health care—relief of symptoms. Palliative care is a great option for patients who are seriously ill and unlikely to fully recover. It focuses on achieving the best possible quality of life for a patient by emphasizing holistic care for all of a patient’s needs (Judson & Harrison, 2019). It goes beyond the physical to include spiritual, social, psychological, and emotional well-being. An important distinction is that palliative care is not restricted to patients near the end of life. It can be used in both acute and long-term care settings. Like hospice, palliative care is the use of an interdisciplinary team of professionals including doctors, nurses, social workers, psychologists, chaplains, and others to provide comprehensive care for the patient. Conclusion No one wants to die, but the reality is that everyone eventually does. How one dies and what the experience is like should be the patient’s decision. The United States is doing a better job today of giving each patient a voice about his or her own way to die.

Reference Judson, K., & Harrison, C. (2019). Law & ethics for health professionals (8th ed.). New York, NY: McGraw-Hill

Education.

Suggested Unit Resources In order to access the following resource, click the link below. Testing for genetic diseases is becoming more and more prevalent. The article below shines some light on this type of testing and the information it may uncover. Nowakowski, R. (2018). Understanding genetic testing for hereditary disease: Your patients may benefit from

such testing to gain more information. Optometry Times, 10(4), 16–20. Retrieved from https://libraryresources.columbiasouthern.edu/login?url=http://search.ebscohost.com/login.aspx?direc t=true&db=asn&AN=129263114&site=ehost-live&scope=site