Common Terms Used In Talking About End-of-Life Care
Advance Directive A general term that describes two kinds of legal documents, living wills and medical powers of attorney. These documents allow you to give instructions about future medical care and appoint a person to make healthcare decisions if you are unable to make them yourself. Each state regulates the use of advance directives differently.
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...
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).
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 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 may 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 goals for care.
Case Law Law that is based on a judge's decision in a court case, rather than by legislation.
Capacity: In the healthcare context, the ability to understand and appreciate the nature and consequences of health care decisions and to make an informed decision. ?e term competent is also used to indicate ability to make informed decisions.
Do-Not-Resuscitate Order (DNR) A DNR order is a physician's written order instructing healthcare providers not to attempt cardiopulmonary resuscitation (CPR) in case of cardiac or respiratory arrest. A person with a valid DNR order will not be given CPR under these circumstances. Although the DNR order is written at the request of a person or his or her family, it must be signed by a physician to be valid.