Advance Directives
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Contents |
More Specific Terms
Introduction
- A document in which a person who has decision-making capacity states choices for medical treatment, or designates an individual for this purpose for use at a time when he/she no longer has decision-making capacity.
- A document in which a person who has decision-making capacity states choices for medical treatment, or designates an individual for this purpose for use at a time when he/she no longer has decision-making capacity.
- An advance directive is NOT to be used as a basis for making medical decisions while the patient still has decision-making capacity (i.e. advance directives ONLY become operative when tha patient has lost decision-making capacity.
- The Patient Self-Determination Act of 1991 requires that all facilities receiving Medicaid or Medicare funding provide patients with written information regarding advance directives.
- Drawbacks:
- discussion between patients & physicians infrequently held
- most discussion focus on interventions, rather than outcomes & willingness to take risks
- patients misunderstand the outcomes of life-sustaining treatments
- goals of care are too frequently not transferred across care settings
- as a result advance directives have had little impact on end of life care
More General Terms
Additional Terms
References
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 582
- Medical Knowledge Self Assessment Program (MKSAP) 11, 14, American College of Physicians, Philadelphia 1998, 2006
- Rosenfeld K. In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- Rosenfeld K. In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 25-28, 2002
- National Guideline Clearinghouse
- Advance directives. In: Evidence-based geriatric nursing protocols for best practice. Hartford Institute for Geriatric Nursing ngc-guideline: [1]
