So the steps we have taken, as organisation, to make sure that if patients tell us that they have an
advanced directive, we store that information at the front of the notes, so that it is immediately obvious and we also electronic alert, on a patient's record, so that there is another way of alerting staff to the fact that there is an
advanced directive.
A doctor, nurse, or social worker can help patients start the process of an
advanced directive, and the forms are available to download online.
But the fact is, many nurses do not have
advanced directives for themselves and their family members.
First,
advanced directives were not celebrated by participants for their ability to secure aggressive life support treatment for patients who wanted to live despite their critical illness, but were criticized for their inability to "prevent unwanted aggressive treatments that prolong dying".
The overall themes are perspectives of international and European law on dignity and self-determination at the end of life;
advanced directives, end-of-life decision-making; and euthanasia in comparative legal perspective; and the ongoing debate on advance directions regulation in Italy.
In 2002, Connell administered a brief survey about
advanced directives to employees at a rural hospital in Western North Carolina.
Cauchi advises that in writing a combined power of attorney for continuing care and
advanced directives, one should resort to written wishes to receive food and water by whatever means until they can no longer be assimilated.
Fallout from the death of Jesica Santillan due to a blood type mix-up continues to plague Duke University Hospital (DUH) after a government inspection found "significant deficiencies" in its dialysis unit and the operation of its
advanced directives program.
A third reason that
advanced directives requesting no resuscitation are ignored is vacillation by the family at the last moment.
So the past decade has seen a tremendous push for living wills and other
advanced directives, while more and more families in hospital waiting rooms find themselves asked if they want "everything done" for their beloved.
Such policies include do not resuscitate, termination of life support, defining brain death, complying with
advanced directives, determining the appropriate surrogate decision maker, triaging, determining capacity to refuse consent to treatment, and other issues.
