Block 2 Decision Making

Question 1

Is competence/incompetence a legal or medical term?

Answer 1

legal term

Question 2

Is Decisional capacity/incapacity a legal or medical term?

Answer 2

medical term

Question 3

Determining decisional capacity is a (blank) judgment.

Answer 3

clinical

Question 4

(blank) requires:
the ability to understand relevant information
appreciate the medical situation and its consequences
communicate a choice
engage in rational deliberation

Answer 4

decisional capacity

Question 5

Who can help to determine decisional capacity?

Answer 5

Psychiatric liason service
Hospital risk managers 
Attorneys
Ethics committees
Consultants

Question 6

What is an authorized person making medical decisions and acting on the patient’s behalf = surrogate.

Answer 6

surrogate decision makers

Question 7

Who can be surrogate decision makers?

Answer 7

• spouse
• adult children
• parents
• adult siblings
• nearest adult relative (adoption/blood)

Question 8

What are the standards for surrogate decisions?

Answer 8

substituted judgment and best interests

Question 9

What was important about Karen Quinlan?

Answer 9

first right to die case due to substituted judgement

Question 10

What was important about Nancy Cruzan?

Answer 10

legal case that hep determined that the decision to refuse treatment should be as informed as the decision to accept treatment i.e need a lot of info to support decision to remove treatment

Question 11

What are the best interest standards?

Answer 11

if pnts own preferences are unknown or unclear, the surrogate must consider the best interests of the patient

Question 12

What are these Important features for?
Discussion with one’s family
Discussion with one’s doctor
Physician documents the conversation in the patient’s record where it can be available when needed.

Answer 12

advanced planning

Question 13

What are advanced directives?

Answer 13

• Durable (or medical) power of attorney for health care
• Directive to Physicians
• Living Will

Question 14

What does this:

• Authorizes a specific decision maker to make medical decisions on the patients behalf.
• These statutes give legal priority to the designated agent over all other parties.

Answer 14

durable power of attorney

Question 15

What does this:

• Documentation of Advance Planning
• Several types
  
  • Directive to Physicians in State Natural Death Acts
    * Living Wills
    * Personal note or letter

Answer 15

Advanced Directives

Question 16

What is this?
“If at any time I should have an incurable injury, disease, or illness certified to be a terminal condition by two physicians, and where the application of life-sustaining procedures would serve only to artificially prolong the moment of my death, and where my physician determines that my death is imminent whether or not life-sustaining procedures are used, I direct that such procedures be withheld or withdrawn, and that I be permitted to die naturally.”

Answer 16

Natural Death Acts directive to physicians

Question 17

What is this?
Less formal
“If I become unable, by reason of physical or mental incapacity, to make decisions about my medical care, let this document provide the guidance and authority about my medical care, let this document provide the guidance and authority needed to make any and all such decisions. If I am permanently unconscious or there is no reasonable expectation of my recovery from a seriously incapacitating or lethal illness or condition, I do not wish to be kept alive by artificial means.”

Answer 17

living will

Question 18

What are the five wishes that should be known in advanced planning?

Answer 18

1) The person I want to make care decisions for me when I can’t.
2) The kind of medical treatment I want or don’t want.
3) How comfortable I want to be.
4) How I want people to treat me.
5) What I want loved ones to know.

Question 19

had a conversation with the pnt and they told you what they wanted so you make that come true despite what you want

Answer 19

substituted judgement