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Advance directives were created in response to the increasing sophistication and prevalence of medical technology. [3] [4] Numerous studies have documented critical deficits in the medical care of the dying; it has been found to be unnecessarily prolonged, [5] painful, [6] expensive, [7] [8] and emotionally burdensome to both patients and their families.
Wishes 1 and 2 are both legal documents. Once signed, they meet the legal requirements for an advance directive in the states listed below.Wishes 3, 4, and 5 are unique to Five Wishes, in that they address matters of comfort care, spirituality, forgiveness, and final wishes.
An advance directive allows an individual to state what treatments he or she would want in a medical crisis, but it is not a medical order. [4] Advance directives are not portable in a sense that it is not accessible across medical systems, so it is the individual's responsibility to have the form on them at all times. [ 4 ]
The advance directive must state that the designated agent has authority to make health care decisions on the patient's behalf and what limitations, if any, are imposed on the agent's authority. The document should clearly state that the agent's authority begins only when the patent is unable to make health care decisions.
The Patient Self-Determination Act (PSDA) was passed by the United States Congress in 1990 as an amendment to the Omnibus Budget Reconciliation Act of 1990.Effective on December 1, 1991, this legislation required many hospitals, nursing homes, home health agencies, hospice providers, health maintenance organizations (HMOs), and other health care institutions to provide information about ...
Psychiatric advance directives are sometimes referred to as Ulysses pacts or Ulysses contracts, where there is a legal agreement designed to override a present request from a legally incompetent patient in favor of a past request made by that previously competent patient. [1]
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