|An Advance Care Directive (‘Living Will’) is a written statement regarding someone’s wishes for their future health care. An Advance Care Directive can be made by anyone who has the capacity to do so. An Advance Care Directive is only used if, at some point in the future, the person becomes incapable of making health care decisions for themselves (due to illness or injury) (Advance Care Directives, 2014). Health care professionals are required to respect patients choices and gain consent (or, at least, assent) prior to providing treatment or care. They are also required to respect patient confidentiality. Based on what you have learned in this unit discuss the ethical issue of informed consent in relation to the following: • What are the features of a valid (legal) consent; and how does this relate to an advanced care directive? • Why does it matter ethically speaking that a patient’s choice be respected? • Are there any expectations to the requirement to respect patient’s choices? • Is Paternalism ever ethically justified in the provision of heath care? • What is the role of the HCP in relation to advocacy for a patient’s wishes and in particular when an advance care directive is present? • What are the legal and professional frameworks that guide a health care professional’s practice in Australia? Consider the above question from the point of view of your own professional prospective and from the perspective of another health care team member. Respond to this question by drawing on what you have studied in this unit for example: relevant codes of conduct, ethics and practice and laws, theories, ethical concepts, principles and values.
Consider the above question from:
1.the point of view of your own professional prospective – e.g. nurse, paramedic, physio
2.the perspective of another health care team member- any HCP including a DR
Respond to this question by:
drawing on what you have studied in this unit for example: relevant codes of conduct, ethics and practice and laws, theories, ethical concepts, principles and values
1. What are the features of a valid (legal) consent; and how does this relate to an advanced care directive?
Briefly outline what the features of a valid legal consent are – do not list- 2-3 sentences
Review what advanced care directives are?
Consider the following questions:
What is an ACD ?– define it, is it a legal document?
Does an ACD constitute valid legal consent?
Are there any circumstances that this might pose an ethical dilemma for a HCP – (you could possibly use this as an opportunity to include some discussion around an example from your own clinical area and then compare this from another HCP clinical area )
Are there any legal ramifications or considerations a HCP needs to consider?
2. Why does it matter ethically speaking that a patient’s choice be respected? Are there any expectations to the requirement to respect patient’s choices?
•Using frameworks and concepts covered in this unit (international and national) discuss why it is ethical to respect patients choices
•In responding to this also draw on an appropriate ethical theory to explain your reasoning. –
?Consider and give an example(s) of when we might not respect a patients wishes? (this is another opportunity to provide a contrast for your own speciality and another HCPs perspective) – What do we call it when we make a decision in the best interests of someone else? You may choose to discuss this here and/or refer to this and use as a link to the next section. (see next slide!)
Can you define it and briefly include this in your discussion around this aspect of the question?
3. Is Paternalism ever ethically justified in the provision of heath care?
?Define paternalism – what is this and when might it be used?
?What sorts of HC situations might justify doing this?
?Discuss this from your own specialty perspective and another HCPs perspective.
?Would it make a difference if there was an ACD in place? Include some discussion around this
?Draw on ethical principles and other theories and HCP professional frameworks to critically analysis this section of the question.
4. What is the role of the HCP in relation to advocacy for a patient’s wishes and in particular when an advance care directive is present?
?What professional and ethical frameworks inform HCP ethical decision making?
?How might a HCP advocate for a patients wishes when there is a ACD in place – think laterally – what might happen if the family disagree for example in organ donation?? OR with resuscitation? OR with turning off a life support machine? –
?Include where possible some perspectives for your own clinical area and another HCPs perspective
5. What are the legal and professional frameworks that guide a health care professional’s practice in Australia?
Students are encouraged to embed understandings about legal, professional and ethical frameworks that inform HCP ethical decision making throughout the essay.