Review the statutory requirements in your state for natural death acts, noting if there is
a specific form that must be followed, requirements for witnesses to the form, and how
long the form is valid.
Natural Death Acts are laws that establish in what situations and how people can decline
life-sustaining medical procedures. In reference to Klingler, in der Schmitten, and Marckmann,
(2016) adults have the fundamental right to govern the decisions relating to providing their
health care, including the decision to have life-sustaining treatment withheld or removed in
circumstances of a terminal condition.
Arizona’s natural death act is a complex piece of legislation. In essence, it proclaims that:
The laws of the State of Arizona recognizes the right of an adult individual to make a written
directive advising his doctor or nurse to withdraw life-sustaining procedures in the case of a
terminal condition (Rodenbach, Tejani, & Epstein, 2016). The law applies only when mentally
competent persons announce (and do not renounce) their intent in a written and witnessed
document. It does not apply to many other cases, such as those involving children or teenagers
(Rodenbach, Tejani, & Epstein, 2016).
The law has several significant implications. It makes clear for the first time that a
physician or health care facility, acting in conformity with a valid directive of a patient, will not
be subject to either civil or criminal liability or claims of unprofessional conduct (Chung,
Oczkowski & Hanvey, 2016).4The proposed Arizona medical aid in the natural death bill would
make it legal for a competent adult suffering from a terminal illness to request and acquire
prescription drugs that would hasten death in a peaceful, humane and dignified manner. Such
medications must be taken by mouth and self-administered if taken (not by injection or other
means). Even if someone else helps with the preparation, they cannot assist with administering
the medication (Rodenbach, Tejani, & Epstein, 2016). Any such hastened death is legally not
suicide.
Discuss if there are additional requirements that must be met in order for the natural
death act to be effective in a given state.
A federal statute, the Patient Self-Determination Act (PSDA), encourages patients to
exercise their rights by signing advance directives, even if each state has its own Natural Death
Act. The PSDA mandates that hospitals and others that receive federal payments inform their
patients of their legal right to make end-of-life medical decisions under applicable state law
(Rodenbach, Tejani, & Epstein, 2016).
What advice would you give a patient or patient's significant others who inquire about
advance directives, living wills, or EOL care in general?
Healthcare providers can play a crucial role in end-of-life care by offering precise
information about medical treatments. According to Schmit, Meyer, Duff, (2016)4nurses can
do their jobs properly by providing patients with comprehensive information about advance
directives. When a patient becomes incapacitated or incapable of communicating with medical
staff and issues an advance directive, it specifies what kind of life-saving medical treatment
the patient wishes to receive after becoming incapacitated or incapable of communicating. For
example, a living will determine whether a person wants to accept life-sustaining medical
interventions. This is an advance directive. Medical proxy (or power of attorney) is another
type of advance directive that appoints another individual to make a choice and may contain
instructions on life support systems.
Summarize an end-of-life case noting the key points that complicated the care of the
patient. After doing so, reflect upon possible current day outcomes based on
policy/legislative changes. Cite a minimum of two reputable references to support your
key points.
A case in reference was that of Dinnerstein, a 67-year-old patient with Alzheimer's
disease, an irreversible and degenerative brain condition. Her illness was deemed terminal when
she had a one-year survival rate and was at constant risk of cardiac or respiratory arrest (Dickens,
1981). There was no viable therapeutic option in this circumstance, whether it was lifesaving or
life extending. A unique challenge arose for the doctors on what steps should be taken to help
this patient cope with the impending loss of her life, given the patient's medical history, current
state, and the wishes of her family (Dickens, 1981).
Non-lawyers who have looked at these cases were in complete disarray. Courts appear to
infer that the contrast between extending one's life is significant (Dickens, 1981). If patients with
a better prognosis have been admitted and inadequate resources exist to give all patients optimal
care, hospital management problems can be adequately addressed, and legal liability issues can
be resolved.
References
Chung, HO., Oczkowski, S.J.W., Hanvey, L.4(2016).4Educational interventions to train
healthcare professionals in end-of-life communication: a systematic review and meta-
analysis.4BMC Med Educ416,131. https://doi.org/10.1186/s12909-016-0653-x
Dickens B. M. (1981). The right to natural death.4McGill law journal. Revue de droit de
McGill,426(4), 847–879. 4https://doi.org//410.7861/clinmedicine.10-3-282
Klingler, C., in der Schmitten, J., & Marckmann, G. (2016). Does facilitated Advance Care
Planning reduce the costs of care near the end of life? Systematic review and ethical
considerations.4Palliative medicine,430(5), 423–433.
https://doi.org/10.1177/0269216315601346
Rodenbach, R. A., Rodenbach, K. E., Tejani, M. A., & Epstein, R. M. (2016). Relationships
between personal attitudes about death and communication with terminally ill
patients: How oncology clinicians grapple with mortality.4Patient education and
counseling,499(3), 356–363. https://doi.org/10.1016/j.pec.2015.10.010
Schmit, J.M., Meyer, L.E., Duff, J.M.4(2016).4Perspectives on death and dying: a study of
resident comfort with End-of-life care.4BMC Med Educ416,297.
https://doi.org/10.1186/s12909-016-0819-6
