Failure of the Current Advance Care Planning Paradigm: Advocating for a Communications-Based Approach
详细信息 查看全文
- 作者：Laura Vearrier
- 关键词：Bioethics ; End of life care ; Medical jurisprudence ; Advance directives ; Advance care planning ; Living wills ; Informed consent ; Resuscitation orders ; Terminal care ; Health communication ; Physician orders for life ; sustaining treatment ; POLST ; Cardiopulmonary resuscitation ; Life support care ; Palliative care ; Decision making
- 刊名：HEC Forum
- 出版年：2016
- 出版时间：December 2016
- 年：2016
- 卷：28
- 期：4
- 页码：339-354
- 全文大小：414 KB
- 刊物类别：Humanities, Social Sciences and Law
- 刊物主题：Philosophy
Ethics
Medical Law
Philosophy of Medicine
Theory of Medicine and Bioethics - 出版者：Springer Netherlands
- ISSN：1572-8498
- 卷排序：28
文摘
The purpose of advance care planning (ACP) is to allow an individual to maintain autonomy in end-of-life (EOL) medical decision-making even when incapacitated by disease or terminal illness. The intersection of EOL medical technology, ethics of EOL care, and state and federal law has driven the development of the legal framework for advance directives (ADs). However, from an ethical perspective the current legal framework is inadequate to make ADs an effective EOL planning tool. One response to this flawed AD process has been the development of Physician Orders for Life Sustaining Treatment (POLST). POLST has been described as a paradigm shift to address the inadequacies of ADs. However, POLST has failed to bridge the gap between patients and their autonomous, preferred EOL care decisions. Analysis of ADs and POLST reveals that future policy should focus on a communications-based approach to ACP that emphasizes ongoing interactions between healthcare providers and patients to optimize EOL medical care to the individual patient.