Ethical Considerations in Executing and Implementing Advance Directives

Perceptions of Preparedness to Assist Elders with End-of-Life Care Preferences

“…This finding differs from other research in which professionals have perceived themselves as unable to provide information on end-of-life care preferences and advance directives (Emanuel, 1994;Gordon & Shade, 1999;Gunter-Hunt et al, 2002;Heyman & Gutheil, 2003;Kapp, 1999;Loewy, 1998;Morrison et al, 1994;Richter et al, 2002). In this present study, respondents perceived themselves as fairly knowledgeable of elders' resources, and had generally positive attitudes toward physician-assisted suicide for elders.…”

“…While advance directives can be technically complicated, most health and allied health professionals need to understand the strengths and limitations of living wills, durable powers of attorney, springingdurable powers of attorney, health care surrogates, and clients' articulated value histories (Kane, 2001;Kapp, 1999). Sadly, there is ample evidence in the literature that professionals' self-perceived understanding of advance directives and end-of-life care preferences is limited (Emanuel, 1994;Gordon & Shade, 1999;Gunter-Hunt, Mahoney, & Sieger, 2002;Heyman & Gutheil, 2003;Kapp, 1999;Loewy, 1998;Morrison, Morrison, & Glickman, 1994;Richter, Eisemann, & Zgonnikova, 2002).…”

“…While these tasks have often been seen as the domain of physicians and nurses, it appears that social workers perceive themselves as capable of assisting clients with end-of-life planning. As noted previously, there is research that indicates that physicians and other medical staff perceive themselves to be uninformed about advance directives and other endof-life care preferences (Emanuel, 1994;Loewy, 1998;Lynn, 1992;Morrison et al, 1994). Many end-of-life care preferences involve knowledge and skill related to the psychosocial well-being and autonomy of clients.…”

The Role of Empirical Research in Bioethics

“…Autonomy in decision-making indeed has become so well accepted that many practitioners have abdicated all responsibility for decision-making, placing the burden squarely on the shoulders of patients. Indeed, some have argued that we are now in the predicament where patients are often “abandoned to their own autonomy” (Loewy 1998, 324). The shift away from paternalistic decision-making to autonomous decision-making in healthcare was not driven by empirical work, rather it was steered by the awareness that people have a right to make important medical decisions.…”

Healthcare Providers Must Offer Palliative Treatment to Parents of Neonates With Hypoplastic Left Heart Syndrome

“…Such a practice has led some to believe that physicians often "abandon patients to their own automony." 36 Given the European trend toward physician directiveness in endof-life decision making and the US trend toward nondirectiveness, American and European critical care and end-of-life professional societies convened a consensus conference in 2003. The outcome was a recommendation for a shared decision-making approach.…”