Week 7: Legal Aspects

Question 1

What’s the difference between wills, ethical wills, holographic will, and living wills

Answer 1

Wills: secular document prepared by an attorney or an online document

Holographic will: prepared and signed, dated in your own handwriting

Ethical wills: a testament of the things you value in life

Living wills: a health care directive

Question 2

What is the difference between advance care planning and end-of-life planning?

Answer 2

Advance care planning: legal documents related to “before death” (advance directives)

End-of-life planning: Documents that include legal “before death” AND “gayer death” (organ donation, wills, funeral/memorial service)

Question 3

More details on advanced care planning

Answer 3

A legal document that takes effect when you become incapacitated, unable to make your wishes known due to disease or injury
- CPR
- Ventilator
- Comfort care

Question 4

What is the 1990/1991 Patient self-determination act?

Answer 4

Requires persons admitted to a health care facility which receives federal funds to inquire about an advance directive and their right to refuse or accept treatment

Question 5

More details to a living will

Answer 5

1976 was the first living will legislation in California “Natural Death Act”
- passed in all 50 states
- Document provided details of what people want done or not one (the intent for people to not have their lives unnecessarily prolonged)

Question 6

What is the difference between power of attorney (financial) and power of attorney for health care

Answer 6

Power of attorney: Person is authorized to make financial decisions on behalf of an individual (checks, transfer real estate)

Power of attorney for health care: Use of a surrogate decision maker to speak on behalf of someone who is unable to do so on his/her own
; preferred over a living will

Question 7

What is 5 wishes?

Answer 7

Valid in 44, used in 50 states

• Wish 1: The Person I Want to Make Care Decisions for Me When I Can’t.
• Wish 2: The Kind of Medical Treatment I Want or Don’t Want.
• Wish 3: How Comfortable I Want to Be.
• Wish 4: How I Want People to Treat Me.
• Wish 5: What I Want My Loved Ones to Know.

Question 8

What is POLST

Answer 8

Physician order for life sustaining treatment
- To ensure that seriously ill person’s wishes regarding life-sustaining treatments are known, communicated, and honored across all health care settings

Question 9

What is NETO?

Answer 9

Nebraska Emergency treatment orders
- Two sided documentL accept, limit, or refuse treatment and then directive on the other side from a physician for EMS

Question 10

What is PMDD?

Answer 10

Protective medical decisions document
- Durable power of attorney health care document
- The person is making decisions on behalf of the individuals that is consistent with the person’s faith tradition

Question 11

What is the difference between DNR and AND?

Answer 11

DNR: do not resuscitate, focused on crisis, model of care

AND: allow natural death, philosophy of providing comfort

Question 12

End of life planning, who is likely to complete? who Is less likely to?

Answer 12

Most:
- Widows
- Whites
- People with income over $75,000
- College education

Least:
- African Americans
- Latinos
- Lower income
- Unmarried
- lower health literacy

Question 13

What are some positives and negative’s of EOL?

Answer 13

Positives:
- People who engage in end of life planning are more likely to prefer hospice and comfort care over hospitalizations at the time of the death
- People who do EOL are more likely to focus on less expensive forms of care

Negatives:
- African Americans and hispanics have a lower completion rate yet have more chronic conditions
- TMT, thinking about death is frightening so competing an advance directive may be avoided because I have to face my mortality

Question 14

What is euthanasia? Active? passive? PAS? mercy killing?

Answer 14

Euthanasia: peaceful, painless exit form life and the intentional foreshortening of a person’s life to spare suffering

Active: intentional action to end life, administration of medication by physician or veterinarian

Passive: intentional withholding of antibiotic or hydration; allowing nature to take its Course

PAS: physician assisted suicide

Mercy killing: extermination

Question 15

Explain the slippery slope

Answer 15

Assisted death could contribute to widespread abuse in other instance
- Go from terminally ill —> poor people

Question 16

Is old age the cause of death?

Answer 16

NO; there are always other underlying conditions

Question 17

Whats the difference between ordinary or extraordinary measures

Answer 17

Ordinary (moral obligation)
- Outcomes are predictable and well known
- Offer no unusual risk, suffering or burden
- Means are effective

Extraordinary (not morally obligated)
- Outcomes are not predictable or well known
- Unusual risk and suffering
- Means may be ineffective

Question 18

What are the 10 states with the death and dignity act?

Answer 18

1. Oregon
2. Washington
3. Montana
4. Vermont
5. California
6. Colorado
7. Washinton, DC
8. Hawaii
9. Maine
10. New Jersey
11. New Mexico

Question 19

In Oregon, what is the primary reason for PAS?

Answer 19

Loss of autonomy

Question 20

MAID in canada, who can get it?

Answer 20

Medical aid in dying
1. Either directly administer the medication
2. Provide a prescription person takes on their own

Must be:
1. 18+ and mentally competent
2. Grievous and irremediable medical condition but does not need to be fatal. Advanced state of decline that is not reversible and unbearable mental and physical suffering
3. Persons with mental illness only will be eligible for MAID after march 17, 2023

Question 21

Death and taxes – what is the exemption amount in 2022?

Answer 21

For people who pass away in 2022, the exemption amount will be $12.06 million (it’s $11.7 million for 2021). For a married couple, that comes to a combined exemption of $24.12 million.