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Health Care Advance Directives

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Health care advance directives are documents that communicate a person's wishes about health care decisions in the event the person becomes incapable of making health care decisions. There are two basic kinds of advance directives: living wills and durable powers of attorney for health care. Durable powers of attorney are the legal basis during advance directives. Legal basis began when the Patient Self-Determination Act, a federal law was passed during 1991. This act requires that the patients are informed about their right to participate in health care decisions, including their right to have an advance directive.(Tonelli, 2008) Advance directives fall into two broad categories: instructive and proxy. Instructive directives allow for preferences regarding the provision of particular therapies or classes of therapies. Living wills are the most common examples of instructive directives, but other types of instructive directives, such as no transfusion and no CPR directives are also employed. The proxy directive, generally a Durable Power of Attorney for Health Care (DPAHC), allows for the designation of a surrogate medical decision maker of the patient's choosing. This surrogate decision maker makes medical care decisions for the patient in the event she is incapacitated. (Tonelli, 2008) The ethical basis for advance directives is pretty much dealing with living wills. A living will expresses a person's preferences for medical care it is called a “living" will because it is in effect while the person is still alive. Living wills become effective only when the person has lost capacity to make health care decisions and the person has a particular condition defined by state law usually a terminal condition or permanent unconsciousness. Some states recognize additional conditions such as an end-stage condition Sabatino, 2007) Many people believe that death is preferable to being perpetually dependent on medical equipment or having no hope of returning to a certain quality of life. Others feel just as strongly that extreme heroic measures and technology should be used to extend life as long as possible, regardless of the degree of medical intervention required or the quality of life that results. A living will allows a person to express either of these preferences or any intermediate measure that the person finds acceptable. (Sabatino, 2007) A situation dealing with a living will is a sick person with Alzheimer, they’re still capable of making their choice. They prefer to be in a room close to the sunlight and have their medicine be given with a specify beverage. Also if they want a certain day to bath, to have visits, to have certain type of clothes to wear that’s them making the choices still not similar to an advanced Alzheimer’s disease. If the person is already really advance then that’s when the person lost total lost capacity to make the healthcare decisions. When that happens it’s called permanent condition.

References
Sabatino, C. (2007, October 1). Advance directives. Retrieved from http://www.merckmanuals.com/home/fundamentals/legal_and_ethical_issues/ advance_directives.html
Tonelli, M. R. (2008, April 11). Advance directives. Retrieved from http://depts.washington.edu/bioethx/topics/advdir.html

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