Advance Directive A general term that describes two kinds of legal documents, living wills and medical powers of attorney. These documents allow you to giveinstructions about future medical care and appoint a person to make health care decisions if you are unable to make them yourself. Each state regulates the use of advance directives differently.
Benefits and Burdens A commonly used guideline for deciding whether or not to begin or stop medical treatments. A benefit can refer to the successful outcome of a medical procedure or treatment. Outcomes can be medical (e.g. the heart beats again) or functional (e.g. the person is able to walk to the bathroom after being incapacitated by a stroke), or one that supports the patient's values (e.g. the patient is able to die at home as wished).
Hannah Kalil is 83 years old, and lives by herself in upstate New York. She has aides who help with her caregiving throughout the day. But the responsibility of managing her finances, health care -- both mental and physical -- and long-term living situation falls to one person: her daughter -- and my mother -- Eleanor.
It's almost a full-time job. Making sure my grandmother is happy and not feeling lonely means daily visits. Her never-ending stream of medical issues means weekly -- if not more frequent...
However, a benefit from one point of view can be experienced as a burden from another and might be viewed differently by doctors, patients and families. For example, if a patient's heart stops, is resuscitated, and the heart starts beating again, this is a successful outcome from a medical point of view and a doctor may consider it a benefit. To the patient who is dying from a serious illness or disease, resuscitation may cause further injury and only contribute to the overall experience of suffering. This success, from the doctor's point of view, might actually be experienced as an additional burden by the patient. Discussions of the benefits and burdens of medical treatments should occur within the framework of the patient's overall condition and goals for care.
Capacity The ability to understand the nature and consequences of health care decisions.
Cardiac Arrest An event in which the heart stops beating, causing all body functions to shut down, including breathing.
Cardiopulmonary Resuscitation (CPR) CPR is the medical treatment used by health care providers to restart the heart and/or restore the breathing of someone who suffers a cardiac or respiratory arrest. CPR involves a group of procedures that may include artificial respiration and intubation to support or restore breathing, and chest compression or the use of electric stimulation or medication to support or restore heart function.