become comfortable and confident in this type of care. One of these opportunities missed by the PICU team itself was notifying the palliative care team when conflict arose; instead of calling that team, the nurse called the hospital social worker, who was unavailable. Calling the palliative care team to assist would have improved the communication and possibly the acceptance of hospice care. 3. There were several confounding factors in Brooke’s hospice referral: The couple’s age, poor socioeconomic status, and living in a rural area with limited access to healthcare providers that delayed identification of health challenges and difficulties. These factors all led to a delay in admission to hospice care and the acceptance of a terminal condition by her family. Death with dignity law refers to an end-of-life option that allows certain qualifying individuals to legally request and obtain medication from their physical to end their life in a dignified matter. Currently, this law is active in 10 jurisdictions, including Washington, Oregon, California, Colorado, New Mexico, New Jersey, Hawaii, Vermont, Maine, and the District of Columbia (https://deathwithdignity.org/). Oregon was the first to legalize this process in 1994. Death with dignity is an end-of-life option, governed by state legislation, that allows certain people with terminal illness to voluntarily and legally request and receive a prescription medication from their physician to hasten their death in a peaceful, humane, and dignified manner. The act outline the process of obtaining such medication, including safeguards to protect both patients and physicians. Death with dignity is a term originating in the title of the Oregon statute governing the prescribing of life-ending medications Advance Directives Advance directives are documents that describe what medical interventions you would want in a life or death situation and/ or you can no longer make decisions for yourself. Aid-in-dying laws cannot be used under advance directives for this reason. Residency Requirements Legal state residency is a requirement for accessing death with dignity laws. Individual must provide adequate documentation to their attending physician to verify that they are a current resident of the jurisdiction with an aid-in-dying statute. It is up to the attending physician to determine whether they have adequately established residency. The state of Oregon is an exception to this as of March 2022. Oregon will no longer require people to be residents of the state to use its law allowing terminally ill people to receive
to eligible people with terminal illness. Other terms include (https://deathwithdignity.org/):
● Physician-assisted death ● Physician-assisted dying ● Aid in dying ● Physician aid in dying ● Medical aid in dying
Incorrect and inaccurate terms that opponents of physician- assisted dying use in order to mislead the public include: ● Assisted suicide
● Doctor-assisted suicide ● Physician-assisted suicide ● (Active) euthanasia
A legal prescription for life-ending medications in available only in states with death with dignity laws (https://deathwithdignity. org/). To qualify under death with dignity statutes, you must be (https://deathwithdignity.org/): ● An adult resident of a state where such a law is in effect ● Capable of making and communicating your own healthcare decisions ● Diagnosed with a terminal illness that will lead to death within six months, as confirmed by qualified healthcare providers ● Capable of self-administering and ingesting medications without assistance Each state’s qualification process may vary. In states where physician-assisted dying is legal, there is no state program for participation in the existing aid-in-dying laws, and people do not apply to state health departments. It is up to eligible patients and licensed physicians to implement the act on an individual, case-by-case basis. Individual is required to be cognitively able to make this decision independently. In cases such as dementia, family is unable to make this request on behalf of the individual, even if this was planned during advanced care planning conversations. lethal medication, after a lawsuit challenged the requirement as unconstitutional. In a settlement filed in U.S. District Court in Portland, Oregon, the Oregon Health Authority and the Oregon Medical Board agreed to stop enforcing the residency requirement and to ask the legislature to remove it from the law (https://www.opb.org/article/2022/03/28/oregon- ends-residency-rule-for-medically-assisted-suicide/). Once an individual is prescribed and provided the medication, they are unable to leave the state where it was administered.
CONCLUSION
This course provided an overview of hospice and palliative care and illuminated the importance and recent growth of this specialty area. It also included a focus on hospice services as defined by the Medicare hospice benefit, quality metrics, and the delivery of care. Increased understanding by nurses and other clinicians is crucial to providing compassionate care. The goal of hospice and palliative care is to reduce the patient’s distressing symptoms (physical, psychological, social, and
spiritual), no matter how young or how old they are, and to improve their quality of life. Making appropriate and timely referrals for hospice and palliative care is one way that clinicians can prevent needless suffering for patients with life-limiting conditions.
Page 257
Book Code: PYFL4024
EliteLearning.com/Psychology
Powered by FlippingBook