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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.
When filing an advance directive, an alternate health care agent should be identified. The surrogate decision maker must be a trusted individual that is able to make crucial decisions on behalf of the advance directive client. The advance directive should also indicate specific instructions for when a patient is incapacitated.
In lawsuits and complaints with state law enforcement officials, hospice families claim their directives were ignored and that loved ones received too many medications, or not enough. The most-watched federal lawsuit, filed last May, accuses Vitas in unusually strong language of harming patients in the pursuit of profits.
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 ...
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