LITERATURE REVIEW

Literature Review



Introduction3

Potential Benefits of Advance Directives6

Possible Limitations of Advance Directives6

The Subjects in an Advance Directive6

Factors of Relevance for an Agent7

Deviation from the Directive8

Consulting the Healthcare Team9

Palliative Care and Advance Directives9

Components of a Directive11

Mandatory Guidelines for Doctors and Relatives13

Patient Consent and Refusal of Care15

The Scope & Duration of Advance Directives15

Literature Review

Introduction

Advance directives for health care are documents that summarize the decisions on the treatment of patients that they entrust to others in the event that they become unable to communicate or make decisions for themselves (Heiman, Bates, Fairchild, Shaykevich, & Lehmann, 2004; Spoelhof & Elliott, 2012). These documents are sometimes called living wills. Exist in most provinces and territories of laws that recognize the right of patients to make decisions about their own care and treatment.

This chapter will present a literature review formed through the analysis and study of the following seven journal articles:

Brown, Beck, Boles & Barrett (1999)

Cugliari, Miller & Sobal (1995)

Heiman, Bates, Fairchild, Shaykevich & Lehmann (2004)

Jezewski, Meeker, Sessanna & Finnell (2007)

Meisel, Snyder & Quill (2000)

Ramsaroop, Reid & Adelman (2007)

Spoelhof & Elliott (2012)

We use the term advance directives to describe information that the patient make in advance, when the patient are capable of understanding, in case the patient would not be able to express the patient's wishes (Brown, Beck, Boles, & Barrett, 1999; Cugliari, Miller, & Sobal, 1995). The patient can specify the type of care the patient want to receive or that the patient refuse on principle. For clarity, it is better to express the patient's advance directives in writing. The patient can choose the shape the patient want to give this document and topics the patient want to include. Your advance directives are signed only by the patient. It is not necessary to have a witness.

Even if the patient have not prepared advance directives, the patient are of course always possible to know the patient's opinion orally, e.g. before surgery. The patient can cancel or change the patient's advance directive at any time (Jezewski, Meeker, Sessanna, & Finnell, 2007; Meisel, Snyder, & Quill, 2000). For example, the patient can make the necessary changes to the document the patient have written, or destroy it. The patient can also orally inform the healthcare professional that the patient's advance directives are no longer valid and provide the patient's current desire.

This is a written, dated and signed with clear identification of its name (s), name (s), date and place of birth. This document can be attested by two witnesses or a doctor, but it is not mandatory. These advance directives are revocable at any time. They may also at any time be modified. Their validity is three years renewable (Ramsaroop, Reid, & Adelman, 2007; Heiman, Bates, Fairchild, Shaykevich, & Lehmann, 2004). They are kept by the patient himself or a loved one. They must be accessible to the treating physician or hospital doctor in his medical record. Any person admitted to a health facility or in a nursing home may indicate the existence of advance directives; mention this as ...