One needs to clarify that the Advance Directive being reviewed is the one that applies in the state of California. Its full official title is “California Advance Health Care Directive” (National Hospice and Palliative Care Organization, 2022, p. 7). A sample of this document was obtained from the digital source of CaringInfo (n.d.) via a download link on one of its web pages. This advance directive closely follows “the Health Care Decisions Act;” it is “the law that establishes advance directives in California” (California medical decision making forms, 2021, para. 1). The document performs only those legal functions prescribed and allowed by this law and uses only permitted professional health terminology in the paper.
Advance Directive’s Principle of Functioning
The California Advance Health Care Directive performs five functions to make it legally easy for patients to get desired and correct treatment and care. The first three are allowing the document subject to identify who can make decisions regarding their health and associated institutional services, making wishes about treatments, and stating a personal perspective on organ donation (National Hospice and Palliative Care Organization, 2022). Others include the juridical designation of the particular medical professional responsible for the person’s health care signing the paper, and containment of the necessary identification and verification elements such as “signature and witnessing provisions” (National Hospice and Palliative Care Organization 2022, p. 3). These mechanisms are needed to ensure and indicate the official nature of patient preference and autonomy within the health care setting.
Feedback on the Content of the California Advance Health Care Directive
After completing the California Advance Health Care Directive, I can say that it was easy in terms of overall semantics and hard regarding terminology. From my perspective, the general meaning of what was written on the pages of the discussed document was easy to understand. However, a significant part of the words associated with jurisprudence and lawmaking caused obstacles in the process of filling in papers. Perhaps this is why not all nurses fully know the essence and functions of advance directives and how to educate patients about this type of document correctly (Miller, 2018). Explanatory footnotes would be a good addition that would facilitate the procedures associated with advance directives for both medical workers and patients.
Physician Orders for Life-Sustaining Treatment (POLST) Form
There is another paper that allows both medical professionals and individuals seeking care and healing to guide the treatment process in the United States health care institution, and it is the Physician Orders for Life-Sustaining Treatment (POLST) form. According to experts, healthcare providers need to complete this form after their patients or representatives are informed that their condition is advanced, chronic, or fatal and cannot be reversed or cured (National POLST, n.d.). The primary purpose of the design of this document is to make the remaining period of an individual’s life safer, more comfortable, and less traumatic.
Participants Involved
It can be said that both parties complete the POLST form even though only medical professionals are legally allowed to fill it out. It is because the opinions and wishes of the patient there carry the same weight as the decisions and prescriptions of the responsible health worker (National POLST, n.d.). Due to this core principle of this process, both groups need to sign the paper. Physicians, their assistants, and nurses are on the first side, and patients and their health care surrogates are on the other.
Differing Elements in Discussed Documents
As one can see, the POLST form differs significantly from other similar documents, Advance Directives especially, as its scope and purpose are narrower and more specific. As described above, the former is designed only for chronically ill persons with fatal conditions and is of rather a voluntary nature (National POLST, n.d.). Whereas the latter is vital for all individuals, whether healthy or sick, and its essence is closer to obligatory. Moreover, the significance of the words of health professionals and the client in these documents is also different. They are equal in POLST form, but professionals’ decisions in Advance Directives are more valid. It is also worth noting that the POLST form contains more proscriptive elements and Advance Directives has many prescriptive ones as fatal conditions exclude many medical practices and medical emergency procedures. In conclusion of this section, their principle of differentiation is specificity versus standard.
Registered Nurses and Patients’ Autonomy in Treatment and Care Decision-Making
Autonomy in making decisions about appropriate treatments and care is a core right of people in need of health care services and resources. According to experts, “nurses and other health care workers should make every effort to educate the patient about the implications of their decisions, but ultimately respect their wishes” (4 ethical dilemmas in nursing, n.d., para. 8). The education provided by Registered Nurses is the key to objective, rational, and effective patient decision-making. Therefore, the efforts of these medical workers are what assure the right to autonomy of clients in healthcare.
References
California medical decision making forms: Advance directives, DNR and POLST. (2021). LibGuides. Web.
CaringInfo. (n.d.). Download and complete your state or territories’ advance directive form. CaringInfo. Web.
4 ethical dilemmas in nursing. (n.d.). Regis College. Web.
Miller, B. (2018). Nurses preparation for advanced directives: An integrative review. Journal of Professional Nursing, 34(5), 369-377. Web.
National Hospice and Palliative Care Organization. (2022). California advance directive: Planning for important health care decisions. CaringInfo. Web.
National POLST. (n.d.). Honoring the wishes of those with serious illness and frailty. National POLST. Web.
