Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Ethics and Professionalism
Lecture:Contemporary topics in medical ethics
Slide content:Advance Directives Living will Do not resuscitate Wishes regarding artificial food or drink Durable power of attorney for health care Designates someone to make decisions Can be combined with instructions in living will 11
Slide notes:Respect for autonomy is a core element of medical ethics. However, sometimes patients reach a point where they are no longer able to decide for themselves about their health care. People use advance directives to make their wishes known in advance if such a situation arises. Two kinds of advance directives are living wills and durable powers of attorney for health care. Sometimes they are contained in one document. The laws governing these documents vary from state to state, but the basic aspects are governed by a federal law called the Patient Self-Determination Act. In a living will, a person describes his or her wishes about life-prolonging care. For example, some people may say they dont want to be resuscitated if their heart stops beating, which is a do not resuscitate, or DNR order. Others may request not to be fed through tubes if they slip into a permanent vegetative state. In a durable power of attorney for health care, individuals assign someone else to make medical decisions for them when they are no longer able to. This document can be combined with a living will. For example, a living will might specify that the person doesnt want artificial feeding but that all other important decisions are left to the judgment of the person named in the power of attorney. 11