Advance Care Directives. Rels 300 / Nurs 330 November 2013.
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Rels 300 / Nurs 330
I, MAXINE, being of sound mind and body, do not wish to be kept alive indefinitely by artificial means. Under no circumstances should my fate be put in the hands of pinhead politicians who couldn't pass ninth-grade biology if their lives depended on it, or lawyers / doctors interested in simply running up the bills. If a reasonable amount of time passes and I fail to ask for at least one of the following:
It should be presumed that I won't ever get better. When such a determination is reached, I hereby instruct my appointed person and attending physicians to pull the plug, reel in the tubes and call it a day.
“Advance health care directives are directions given by a competent individual concerning what, how, and/or by whom health care decisions should be made in the event that the individual becomes incompetent to make these decisions in the future.”
In NS, new legislation in 2009 recognized both instruction directives and proxy directives – previously, only proxy directives.
About Advance Care Planning
It’s about conversations.
It’s about decisions.
It’s how we care for each other.
Questions to discuss with family members:
How many of the previous questions would you be able to answer on behalf of your:
WELLNESS WORKSHEET 108
Advance Medical Directives
(Emanuel & Emanuel)
Scenario A = Nancy Cruzan
What choices would you make in this scenario?
Listen to a conversation
Jill & Phil say: ‘Do not resuscitate’(video clip 5:01)
Complete the Wellness Worksheet, Situation E, imagining that at some time in your future you might develop an incurable chronic illness.
Scenario E = Jill Brooks
What choices would you make?
“On the 1st of February my wife was walking to a second-hand bookshop where she was due to stand in for the normal book shop helper. Her route crossed the main Derby Ring Road at a point where there is no pedestrian crossing. The view both for pedestrians and drivers is not bad. There are about 10 seconds between a car appearing round the bend and reaching the crossing point if travelling at the allowed 40 mph, and there was no evidence that the car that hit her was travelling too fast…
“She suffered numerous limb fractures but the most serious damage was to her brain where extensive haemorrhaging had taken place. This was made clear by the MRI. Her brother and two daughters and I were all there. The surgeon told us that, over time, he could mend her bones but not her brain.”
Yes, you do.A patient's advance refusals of treatment are legally binding if
If you don't follow a valid advance directive, you may be vulnerable to professional discipline and/or a lawsuit by the patient or the patient's family.
As a healthcare provider, what do I do if I think that the patient's proxy is not respecting the patient's prior expressed wishes, or is not acting in the patient's best interests?
“…a competent person has the right to refuse, or withdraw consent to, any clinically induced treatment, including life-saving or life-sustaining treatment.
“…when a person is incompetent, treatment decisions must be based on his or her wishes as expressed in advancedirectives or similar instruments.
“Where a person’s wishes are not known, treatment decisions must be based on what is in the person’s best interests; part of the process for determining this involves consultations withthose who are significant in the person’s life.”
[Canadian AIDS Society]
Released as part of Dying Matters Awareness Week 2012, this carefully crafted short film was created to act as a stimulus for making end of life wishes clear and changing the way the nation thinks about death.
Raising awareness of dying, death and bereavement