The Advance Health Care Directives are documents that individual state choices about the medical treatment or the name of someone who can decide on your medical treatment when you are critically sick. The most common advanced directive (AD) present in my current working organization in Florida is the Living Will declaration.
I obtained the living will declaration document from the Official Florida Forms websites https://eforms.com/living-will/florida-living-will-form/. This AD complies with Florida state laws in several ways. First, the Living will go into effect to comply with the Florida states laws, which outline the doctor should have a copy and conclude an individual cannot make their health care decision. Besides, the living will do not affect life insurance policies under Florida laws. Besides, the Living Will is signed before two witnesses according to the minimum requirements of Florida laws, although it does not restrict the people who can act as witnesses.
The Living Will is a document that tells your doctor and health care providers whether you want life-prolonging treatments or procedures administration when you are in a terminal condition, persistent vegetative state, and end-stage condition (Cleveland Clinic, nd). According to Florida laws, a doctor or any health caregiver cannot be sued or executed for unethical conduct because of implementing the Living Will. The Living Will describes specific medical treatment want or not, which usually life-prolonging treatments such as kidney dialysis, mechanical respirators, and cardiopulmonary resuscitation (CPR) (Levenson & Zucker, 2017). Before the health care team uses your Living will, a minimum of two physicians should confirm that an individual cannot make their own medical decision since they are in a terminal or permanently unconscious state.
One of the difficulties I had when signing the Living Will was the likelihood of physicians collaborating with a patient to end their lives or deciding to effect it before the right time. Some healthcare givers may omit some essential medical treatments in collaboration with cruel family and society members to end a persons' life. The other difficulty was selecting the right witness as either a spouse or a lawyer who can play an essential role in promoting the business. The other disturbing issue was the inability of my family to override my Living Will to provide the best health care treatment since they cannot take away my authority. A reasonable degree exists of a person making a wrong decision when signing the Living Will, hindering the family from implementing the proper medical treatment plan.
A Physician Orders for Life-Sustaining Treatment (POLST) form refers to a physician's order that presents a plan of end of life care based on the patient's preferences about health care at their end times and the physician's judgment based on medical evaluation. The main aim of the POLST is to allow a physician and the patient to develop default orders about ending life care that can be issued to other health care professionals, emergency personnel, and facilities. The POLST is strongly considered for patients whose death within the next twelve months will not be surprising due to their current health condition state (Mehta & Blackhall, 2020). However, it may be applicable for patients living in long-term care facilities due to terminal illnesses facilitating the inability of the patient to make decisions.
The POLST form should be completed when the patient's health condition indicates a high possibility of death occurring within twelve months. In most cases, the POLST form is completed when the physician evaluates and determines the patient is suffering from a terminal illness or permanent unconsciousness as specified by the State law. According to Florida laws, the POLST form completion should be done when the patient's physician determines the patient is in a terminal condition, persistent vegetative state, or end-stage condition. These are the appropriate states that observe personal will since other people's will cannot overthrow it.
The POLST form can be completed by the patient and the physician taking health care on them. However, the form may be completed by the patient's legally recognized decision-maker if the patient cannot complete and sign the document (Mehta & Blackhall, 2020). In addition, the form may also be completed by someone who has undergone special training about POLST and who is working with the patient's physician.
For the POLST form to be legal, the patient must sign the physician. However, if the patient cannot sign the document due to their current health condition, their legally recognized decision-maker may sign it.
Summary and Conclusion
Although Advanced Directives such as the Living will and POLST are important documents concerning individuals' end-of-life wishes, they have differences. For instance, a POLST is a physician or doctor's order while the Living will is a legal document signed prior to health deterioration of the patient's health condition. POLST is an essential document which focuses on immediate treatment mainly for health emergencies since it is a medical order. On the other hand, a Living will is a legal document that present a persons' older adult's end-of-life preferences that are usually made before health deterioration emerges. Therefore, it is an important document that guides the personal health decision-making process in the future, including implementing a POLST.
The RN's important role in assuring patient's right to autonomy in choosing health care interventions is communicating and organizing their work to implement the patient's decision and will. Through, effective communication all the details in an end-time-wishes for the patient will be delivered to the essential parties involved in the patient health care services. Besides, RN's has the role of ensuring effective implementation of the patient's will by preserving and reviewing the overall statements of the advanced directives such as the Living Will.
In conclusion, the POLST and the Living Will are necessary to document and guide an individual's end-time wishes. However, they have differences in their implementation and formulation as ta doctor orders the POLST. The RN's plays a vital role in promoting individual autonomy in health decision-making through communication and enhancing the will implementation.
Cleveland Clinic. (n.d.). Cleveland Clinic: Every Life Deserves World Class Care. https://my.clevelandclinic.org/-/scassets/files/org/patients-visitors/information/aco/florida-advance-directives-19.ashx?la=en
Levenson, J. D., & Zucker, K. (2017). The practical distinction between living wills and physician (Pennsylvania) orders for life-sustaining treatment (POLST). Journal of Legal Medicine, 37 (sup1), 52-54.
Mehta, A. K., & Blackhall, L. J. (2020). Physician Orders for Life-Sustaining Treatment and ICU Admission Near the End of Life. Jama, 324 (6), 608-608.
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