Ethical Considerations

Question 1

Patient self-determination act

Answer 1

December 1991
Established guidelines to allow patients to participate in decision regarding their care. Particularly in situation involving severe or terminal illness.
Older patients grew up trusting doctor’s decisions as final.
Younger patients may be skeptical. Include patient’s family.

Question 2

Advanced Directive

Answer 2

Statement with decsion making capcitty indicating person’s preferences fore receiving medical treatment or not receiving medical treatment under certain circumstances

Question 3

Waht documents often comprise advanced directive

Answer 3

Living Will

Power of ATtorney

Question 4

What’s a living will?

Answer 4

Legal document in whcih you state your wishes regarding your future health care.
Typically intended to apply in situations such as terminal illness, permanent unconsciousness, conscious but with irreversible brain dmaage such that can never regain the abilit to make decisions

Question 5

Who decides that the patient has decision making ability.

Answer 5

Team decision involving social worker, case worker, The SLP informs about cognitive status and barriers that exist to decision making.

Question 6

How do medical professionals acess a will

Answer 6

person must tell their family where and how to access it, and then the family brings it to the medical professionals.

Question 7

What’s power of attorney

Answer 7

Allows you to appoint another person to make decisions about your medical care in the event that you’re unable to make the decisions yourself.
There are state law rules about power of attorney if person doesn’t legally appoint one

Question 8

What’s power of attorney

Answer 8

Allows you to appoint another person to make decisions about your medical care in the event that you’re unable to make the decisions yourself.
There are state law rules about power of attorney if person doesn’t legally appoint one

Question 9

What populations bnefit from PEG

Answer 9

head and neck cancer

acute stroke wit dysphagia

Question 10

What are common misconceptions about PEG placement in advanced dementia

Answer 10

prevents aspiration (actually slight increase in aspiration pneumonia risk)
prolongs life
improves nutrition (doesnt improve nutrition because body absorbs nutrients differntly in process of dying)
improves function

Question 11

What are Atul Gawande’s 5 questions

Answer 11

5 questions that you or family member can answer. Things that need to be talked about frequently and reassessed.
What’s your understanding of where you are in your illness?
What ar your worries or fears for the future?
What are your goals and priorities?
What outcomes are unacceptable to you? What are you willing to sacrifice or not?
What would a good day look like?

Question 12

What is palliative care and hospice?

Answer 12

Specialized medical care for people with serious illness.
Focus on providing relief from symptoms.
The goal is to improve quality of life, not necessarily health, reagardless of medical condition.

Question 13

When making end of life decisions what do we do?

Answer 13

Provide education and then leave it up to family and patient to make the decision.