Related Research Articles
An advance healthcare directive, also known as living will, personal directive, advance directive, medical directive or advance decision, is a legal document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity. In the U.S. it has a legal status in itself, whereas in some countries it is legally persuasive without being a legal document.
A do-not-resuscitate order (DNR), also known as Do Not Attempt Resuscitation (DNAR), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), no code or allow natural death, is a medical order, written or oral depending on the jurisdiction, indicating that a person should not receive cardiopulmonary resuscitation (CPR) if that person's heart stops beating. Sometimes these decisions and the relevant documents also encompass decisions around other critical or life-prolonging medical interventions. The legal status and processes surrounding DNR orders vary in different polities. Most commonly, the order is placed by a physician based on a combination of medical judgement and patient involvement.
Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy, non-maleficence, beneficence, and justice. Such tenets may allow doctors, care providers, and families to create a treatment plan and work towards the same common goal. These four values are not ranked in order of importance or relevance and they all encompass values pertaining to medical ethics. However, a conflict may arise leading to the need for hierarchy in an ethical system, such that some moral elements overrule others with the purpose of applying the best moral judgement to a difficult medical situation. Medical ethics is particularly relevant in decisions regarding involuntary treatment and involuntary commitment.
Geriatrics, or geriatric medicine, is a medical specialty focused on providing care for the unique health needs of the elderly. The term geriatrics originates from the Greek γέρων geron meaning "old man", and ιατρός iatros meaning "healer". It aims to promote health by preventing, diagnosing and treating disease in older adults. There is no defined age at which patients may be under the care of a geriatrician, or geriatric physician, a physician who specializes in the care of older people. Rather, this decision is guided by individual patient need and the caregiving structures available to them. This care may benefit those who are managing multiple chronic conditions or experiencing significant age-related complications that threaten quality of daily life. Geriatric care may be indicated if caregiving responsibilities become increasingly stressful or medically complex for family and caregivers to manage independently.
Polypharmacy (polypragmasia) is an umbrella term to describe the simultaneous use of multiple medicines by a patient for their conditions. The term polypharmacy is often defined as regularly taking five or more medicines but there is no standard definition and the term has also been used in the context of when a person is prescribed 2 or more medications at the same time. Polypharmacy may be the consequence of having multiple long-term conditions, also known as multimorbidity and is more common in people who are older. In some cases, an excessive number of medications at the same time is worrisome, especially for people who are older with many chronic health conditions, because this increases the risk of an adverse event in that population. In many cases, polypharmacy cannot be avoided, but 'appropriate polypharmacy' practices are encouraged to decrease the risk of adverse effects. Appropriate polypharmacy is defined as the practice of prescribing for a person who has multiple conditions or complex health needs by ensuring that medications prescribed are optimized and follow 'best evidence' practices.
Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990), was a landmark decision of the Supreme Court of the United States involving a young adult incompetent. The first "right to die" case ever heard by the Court, Cruzan was argued on December 6, 1989, and decided on June 25, 1990. In a 5–4 decision, the Court affirmed the earlier ruling of the Supreme Court of Missouri and ruled in favor of the State of Missouri, finding it was acceptable to require "clear and convincing evidence" of a patient's wishes for removal of life support. A significant outcome of the case was the creation of advance health directives.
Program of All-inclusive Care for the Elderly (PACE) are programs within the United States that provide comprehensive health services for individuals age 55 and over who are sufficiently frail to be categorized as "nursing home eligible" by their state's Medicaid program. The ultimate goal of PACE programs is to keep eligible older adults out of nursing homes and within their communities for as long as possible. Services include primary and specialty medical care, nursing, nutrition, social services, therapies, pharmaceuticals, day health center services, home care, health-related transportation, minor modification to the home to accommodate disabilities, and anything else the program determines is medically necessary to maximize a member's health. If you or a loved one are eligible for nursing home level care but prefer to continue living at home, a PACE program can provide expansive health care and social opportunities during the day while you retain the comfort and familiarity of your home outside of day hours.
The American Geriatrics Society (AGS) is a non-profit professional society founded on June 11, 1942, for health care professionals practicing geriatric medicine. Among the founding physicians were Dr. Ignatz Leo Nascher, who coined the term "geriatrics", Dr. Malford W. Thewlis, who was named the first executive secretary of the Society, and Dr. Lucien Stark who was appointed the first AGS president.
An angel of mercy or angel of death is a type of criminal offender who is usually employed as a medical practitioner or a caregiver and intentionally harms or kills people under their care. The angel of mercy is often in a position of power and may decide the victim would be better off if they no longer suffered from whatever severe illness is plaguing them. This person then uses their knowledge to kill the victim. In some cases, as time goes on, this behavior escalates to encompass the healthy and the easily treated.
End-of-life care (EOLC) is health care provided in the time leading up to a person's death. End-of-life care can be provided in the hours, days, or months before a person dies and encompasses care and support for a person's mental and emotional needs, physical comfort, spiritual needs, and practical tasks.
Geriatric intensive care unit is a special intensive care unit dedicated to management of critically ill elderly.
"Death panel" is a political term that originated during the 2009 debate about federal health care legislation to cover the uninsured in the United States. Sarah Palin, former governor of Alaska and 2008 Republican vice presidential candidate, coined the term when she charged that proposed legislation would create a "death panel" of bureaucrats who would carry out triage, i.e. decide whether Americans—such as her elderly parents, or children with Down syndrome—were "worthy of medical care". Palin's claim has been referred to as the "death panel myth", as nothing in any proposed legislation would have led to individuals being judged to see if they were worthy of health care.
A surrogate decision maker, also known as a health care proxy or as agents, is an advocate for incompetent patients. If a patient is unable to make decisions for themselves about personal care, a surrogate agent must make decisions for them. If there is a durable power of attorney for health care, the agent appointed by that document is authorized to make health care decisions within the scope of authority granted by the document. If people have court-appointed guardians with authority to make health care decisions, the guardian is the authorized surrogate.
POLST is an approach to improving end-of-life care in the United States, encouraging providers to speak with the severely ill and create specific medical orders to be honored by health care workers during a medical crisis. POLST began in Oregon in 1991 and currently exists in 46 states, British Columbia, and South Korea. The POLST document is a standardized, portable, brightly colored single page medical order that documents a conversation between a provider and an individual with a serious illness or frailty towards the end of life. A POLST form allows emergency medical services to provide treatment that the individual prefers before possibly transporting to an emergency facility.
Advance care planning is a process that enables individuals with decisional mental capacity to make plans about their future health care. Advance care plans provide direction to healthcare professionals when a person is not in a position to make and/or communicate their own healthcare choices. Advance care planning is applicable to adults at all stages of life. Participation in advance care planning has been shown to reduce stress and anxiety for patients and their families, and lead to improvements in end of life care. Older adults are more directly concerned as they may experience a situation where advance care planning can be useful. However, a minority use them. A research conducted in Switzerland with people aged 71 to 80 showed that better knowledge on advance care planning dispositions could improve the perception older people have of them. Communication on dispositions should take into account individual knowledge levels and address commonly enunciated barriers that seem to diminish with increased knowledge.
Vallalarpuram Sennimalai Natarajan is an Indian geriatric physician, considered by many as the Father of Geriatric Medicine in India and known to be the first Indian Professor in the discipline. He was honored by the Government of India, in 2012, with the fourth highest Indian civilian award of Padma Shri.
Sterilization law is the area of law, within reproductive rights, that gives a person the right to choose or refuse reproductive sterilization and governs when the government may limit this fundamental right. Sterilization law includes federal and state constitutional law, statutory law, administrative law, and common law. This article primarily focuses on laws concerning compulsory sterilization that have not been repealed or abrogated and are still good laws, in whole or in part, in each jurisdiction.
John C. Beck was an American physician and academic. He was particularly involved in the Royal Victoria Hospital and McGill University; the David Geffen School of Medicine at UCLA; and Ben Gurion University of the Negev.
Marjory Winsome Warren is one of the first geriatricians and considered the mother of modern geriatric medicine.
That Good Night: Life and Medicine in the Eleventh Hour is a 2019 memoir written by Sunita Puri, a palliative care physician who chronicles her experiences with helping terminally-ill patients and their family members make end-of-life decisions. She further explores the dichotomy between modern medicine and palliative care. Throughout the span of 13 chapters, Puri recounts clinical encounters involving both patients and professional colleagues, stories of her upbringing, and personal reflections about the field of palliative medicine. The book was published by Penguin Random House in 2019.
References
- ↑ Grisso, Thomas; Appelbaum, Paul S. (1998). Assessing competence to consent to treatment: a guide for physicians and other health professionals. New York: Oxford University Press. p. 159. ISBN 0195103726.
- 1 2 Molloy, David W.; Roger M. Clarnette, E. Ann Braun, Martin R. Eisemann, B. Sneiderman (April 1991). "Decision Making in the Incompetent Elderly: 'The Daughter from California Syndrome'". Journal of the American Geriatrics Society . 39 (4): 396–399. doi:10.1111/j.1532-5415.1991.tb02907.x. PMID 2010590. S2CID 44780093.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ↑ Byrne, Nicola (2008). Psychiatry: Clinical Cases Uncovered. Wiley. p. 72. ISBN 9781405159838.
- ↑ Steinberg, Maurice D.; Youngner, Stuart J., eds. (1998). End-of-life decisions: a psychosocial perspective (1st ed.). Washington, D.C.: American Psychiatric Press. p. 92. ISBN 0880487569.
- ↑ Bruera, Eduardo; Portenoy, Russell K., eds. (1997). Topics in Palliative Care. New York: Oxford University Press. p. 317. ISBN 0195102452.
- ↑ Volandes, Angelo (2015). The Conversation: a Revolutionary Plan for End-of-Life Care. New York: Bloomsbury. pp. 60–61. ISBN 978-1620408544.