Health Law IV Flashcards
Who is allowed to forego a life sustaining procedure in Iowa?
A qualified individual
What is a “qualified individual” in terms of refusing care?
- A person who has executed a declaration
- Has signed a DNR
What are the two qualifications of a DNR order that must be met?
- Attending has declared “terminal condition”
- Confirmed and documented by a second physician
What qualifies as a “life sustaining procedure”? What are the two qualifications that must be met?
Any medical procedure, tx, or intervention meeting BOTH of the following:
- Uses mechanical or artificial means to sustain, restore, or supplant a spontaneous function
- When applied to a patient in a terminal condition, would serve only to prolong the dying process
Life sustaining procedures does not include nutrition or hydration, except under what three conditions?
- from IV catheter
- Intubation
- When deemed necessary for comfort care or to alleviate pain
What is the legal definition of a terminal condition? (2)
- An incurable or irreversible condition that, without the administration of a life-sustaining procedure, will, in the opinion of the attending, result in death within a relatively short period of time
- State of permanent unconsciousness
What are the two qualifications that must be met to have a terminal condition based on a permanent state of unconsciousness?
- To a reasonable degree of medical certainty (not 100%)
- There can be no recovery
What are the two criteria that must be met to be competent enough to make a declaration?
- Declarant’s condition must be terminal
- Declarant is unable to make own decision
True or false: a competent adult may issue a declarant at any time
True–but declaration is only given effect if met conditions
What are the two things that a documented declaration of terminal decision must have?
- Signed by a declarant
- Contain a date of execution
How many people must witness the declaration of terminal illness?
2 people
True or false: when signing a declarant, the two witnesses must both be present at the same time
True
Who cannot be a witness to a declarant?
- at least 1 witness cannot be related
- Neither witness is health care provider, an employee of a health care provider, or under 18
True or false: a witness to a declarant can be a health care provider, or an employee of a health care provider
False
True or false: a witness of a declarant cannot be under 18 yo
True
True or false: the two witnesses to a declarant can be related to the patient
False–at least 1 witness cannot be related
What is the reasoning behind not allowing a doctor to be a witness of a declaration?
Dr may be influenced to have patient sign declarant
True or false: as a physician, you can never sign a declarant as a witness
False–as long as you’re not acting in medical provider capacity, you can
Does a living will made in another state have effect in Iowa?
Yes, but needs to meet state requirements
What should be done with a declaration?
Give to physician
If a person does not have a living will, specific steps must be taken before what can be done? (2)
- Before a person can be removed from life support
- Before life support may be withheld
What are the steps that must be taken before you can withhold or withdraw life support in a patient without a living will?
- Person must suffer terminal condition
- Attending must consult with, and obtain written consent
- Surrogate must be guided by the wishes of the patient
- Perform action with a witness
What is the order of people who can give consent for an incapacitated patient? (6)
- Designated attorney
- Guardian
- Spouse
- Adult children
- Parent
- Adult sibling
What happens when adult children disagree on treatment of a patient?
Majority rules
