Honoring Patient Autonomy at End-of-life decisions.Thesis Introduction: It is the right of every competent patient to make decisions regarding medical treatment.

Honoring Patient Autonomy at End-of-life decisions.Thesis Introduction: It is the right of every competent patient to make decisions regarding medical treatment.

IRP Outline
Honoring Patient Autonomy and End-of-Life Decision-making
Thesis Introduction: It is the right of every competent patient to make decisions regarding medical treatment. When a patient is informed and educated on the risks versus benefits, he/she can make choices without the inference of the healthcare proxy. End-of-life issues are even more difficult. Unfortunately, by adhering to the current standards, patients have suffered from not being able to make decisions that are followed through by health care professionals. This is because of numerous reasons. The purpose of this paper will show research and discuss current options to preserve patient autonomy, examine policies/procedures that surround end-of-life, case law and current legislation. My thesis will conclude by proposing changes in policies to better protect patients and preserving patient autonomy.
Definition of patient autonomy
What is autonomy?
“The right of patients to make decisions about their medical care without their health care provider trying to influence the decision. Patient autonomy does allow for health care providers to educate the patient but does not allow the health care provider to make the decision for the patient.”
Define Problem
End-of-life is a difficult time for all and should not be complicated by having family members, physicians or judicial system trying to predict what treatments patients would have wanted. A competent patient should be able to make medical decisions without any meddling from healthcare professionals.
Identify goal
The primary goal of protecting patient autonomy is to preserve the human dignity and autonomy of the person. The ultimate hope would be for all members of society to make their wishes known to healthcare professionals and the healthcare proxy would abide by them.
Background/History
Patient Self-Determination Act (PSDA): The Federal Patient Self-Determination Act confirms the fact that autonomy is one of the core ethics in American healthcare, if not the dominant ethic. Consistent with this, when patients are able to speak for themselves, informed consent is a fundamental prerequisite to providing care. When patients are unable to speak for themselves, the American medical and legal system still strives to ensure that patients’ autonomy is respected with the use of advance directives. Provide written information to all adult patients on their rights under state law to make decisions—including information about the right to execute an advance directive and how the institution implements them.
Document presence of an advance directive in a patient’s medical record.
Provide education for staff and the community about advance directives.
Incomplete Advance Directives: The Agency for Healthcare Research and Quality (AHRQ) studies found only 18-36 percent of the adult population have completed advance directives and less than 50 percent of the severely or terminally ill patients studied had an advance directive.
Importance of Improving Patient Autonomy
Improving patient-physician relationship
Lessons learned from Terri Schiavo case: This is a well-known case raised many emotional and complex issues about the end of life. This case exhibits the difficulty in surrogate decision making that occurs all the time in the healthcare setting. It shows that the need for end-of-life documentation that clearly states the wishes of the patient


 

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