Healthy Vision 2020
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Healthy Vision 2020
Bringing into focus a clear and distinct view of the rest of this decade in Texas health care. Offering a sharp perception of what lies ahead and what we must change to keep us all healthy.
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End-of-life talks lacking between doctors, patients

End-of-life talks lacking between doctors, patients | Healthy Vision 2020 | Scoop.it
NEW YORK (Reuters Health) - Although many older patients in Canada have thought about end-of-life care and discussed it with family members, a new study suggests fewer have spoken with doctors and had...
Texas Medical Association's insight:

Respect patients in their final days

 

Thanks to the advancements of medicine and science, Texans are living longer. However, these blessings bring the challenges of care and treatment decisions in life’s final stages. Advance directives allow patients to make their end-of-life treatment decisions known in the event they become incapable of communication or incompetent. Without advance directives, some of life’s most difficult decisions are being thrust upon unprepared adult children, parents, or other loved ones.

 

At each step, human beings are involved in both deciding on and providing treatment. We must respect the value of life and the moral conscience of those involved.

 

Texas physicians abide by the Code of Medical Ethics, which includes “First, do no harm.” For this reason, TMA supports the Texas Advance Directives Act (TADA). Its aim is to allow patients to make their care preferences known before they need care, and to protect patients from discomfort, pain, and suffering due to excessive medical intervention in the dying process. The time may come when all that can be done for a patient is to alleviate pain and suffering, and preserve the patient’s dignity. For physicians, this is about medical ethics and providing medically appropriate care.

 

Then-Gov. George W. Bush signed TADA into law in 1997. It had unanimous support from physicians, nurses, hospitals, nursing homes, hospice care facilities, and pro-life organizations. The law provides a balanced approach to addressing one of life’s most difficult decisions.

 

TADA allows a patient to issue an out-of-hospital do-not-resuscitate (DNR) order, a medical power of attorney, or a directive for physicians and family members regarding the person’s wishes to administer or withhold life-sustaining treatment in the event the person is in a terminal or irreversible condition and unable to make his or her wishes known. Additionally, when an attending physician morally disagrees with a health care or treatment decision made by or on behalf of a patient, the act provides for a process whereby an ethics or medical committee reviews the physician’s refusal. The patient is given life-sustaining treatment during the process. If the ethics committee decides that discontinuing lifesaving treatment is in the best interest of the patient, and the family disagrees with that decision, the hospital must continue treatment for 10 days to allow the family some time to find a different facility for the dying patient.

 

Legislation has been introduced in the past two legislative sessions that would instead require indefinite treatment.

 

TMA has opposed the proposed legislation because it would prolong unnecessary — and often painful — care. It would require physicians, nurses, and other health care professionals to provide medically inappropriate care, even if that care violates medical ethics or the standard of care. It also sets a dangerous precedent for the legislature to mandate the provision of physician services and treatments that may be medically inappropriate, outside the standard of care, or unethical.

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Legislators struggle again with end-of-life decisions

Legislators struggle again with end-of-life decisions | Healthy Vision 2020 | Scoop.it
For the fifth consecutive session, Texas legislators are struggling with an emotionally and politically delicate issue — how to resolve end-of-life disputes when doctors seek to let a patient die against the family’s wishes.
Texas Medical Association's insight:

Respect patients in their final days

 

Thanks to the advancements of medicine and science, Texans are living longer. However, these blessings bring the challenges of care and treatment decisions in life’s final stages. Advance directives allow patients to make their end-of-life treatment decisions known in the event they become incapable of communication or incompetent. Without advance directives, some of life’s most difficult decisions are being thrust upon unprepared adult children, parents, or other loved ones.

 

At each step, human beings are involved in both deciding on and providing treatment. We must respect the value of life and the moral conscience of those involved.

 

Texas physicians abide by the Code of Medical Ethics, which includes “First, do no harm.” For this reason, TMA supports the Texas Advance Directives Act (TADA). Its aim is to allow patients to make their care preferences known before they need care, and to protect patients from discomfort, pain, and suffering due to excessive medical intervention in the dying process. The time may come when all that can be done for a patient is to alleviate pain and suffering, and preserve the patient’s dignity. For physicians, this is about medical ethics and providing medically appropriate care.

 

Then-Gov. George W. Bush signed TADA into law in 1997. It had unanimous support from physicians, nurses, hospitals, nursing homes, hospice care facilities, and pro-life organizations. The law provides a balanced approach to addressing one of life’s most difficult decisions.

 

TADA allows a patient to issue an out-of-hospital do-not-resuscitate (DNR) order, a medical power of attorney, or a directive for physicians and family members regarding the person’s wishes to administer or withhold life-sustaining treatment in the event the person is in a terminal or irreversible condition and unable to make his or her wishes known. Additionally, when an attending physician morally disagrees with a health care or treatment decision made by or on behalf of a patient, the act provides for a process whereby an ethics or medical committee reviews the physician’s refusal. The patient is given life-sustaining treatment during the process. If the ethics committee decides that discontinuing lifesaving treatment is in the best interest of the patient, and the family disagrees with that decision, the hospital must continue treatment for 10 days to allow the family some time to find a different facility for the dying patient.

 

Legislation has been introduced in the past two legislative sessions that would instead require indefinite treatment.

 

TMA has opposed the proposed legislation because it would prolong unnecessary — and often painful — care. It would require physicians, nurses, and other health care professionals to provide medically inappropriate care, even if that care violates medical ethics or the standard of care. It also sets a dangerous precedent for the legislature to mandate the provision of physician services and treatments that may be medically inappropriate, outside the standard of care, or unethical.

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Artificial death extension: It means that I actually care

Instead of offering artificial life support to these patients, I will be offering artificial death extension.

 

Texas physicians abide by the Code of Medical Ethics, which includes “First, do no harm.” For this reason, TMA supports the Texas Advance Directives Act (TADA). Its aim is to allow patients to make their care preferences known before they need care, and to protect patients from discomfort, pain, and suffering due to excessive medical intervention in the dying process. The time may come when all that can be done for a patient is to alleviate pain and suffering, and preserve the patient’s dignity. For physicians, this is about medical ethics and providing medically appropriate care. 

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Comfort care goes beyond DNR orders

Comfort care goes beyond DNR orders | Healthy Vision 2020 | Scoop.it
These are difficult decisions to make as a doctor and a son. It is very challenging to be objective when the questions are about your own father.
Texas Medical Association's insight:

Respect patients in their final days

 

Thanks to the advancements of medicine and science, Texans are living longer. However, these blessings bring the challenges of care and treatment decisions in life’s final stages. Advance directives allow patients to make their end-of-life treatment decisions known in the event they become incapable of communication or incompetent. Without advance directives, some of life’s most difficult decisions are being thrust upon unprepared adult children, parents, or other loved ones.

 

At each step, human beings are involved in both deciding on and providing treatment. We must respect the value of life and the moral conscience of those involved.

 

Texas physicians abide by the Code of Medical Ethics, which includes “First, do no harm.” For this reason, TMA supports the Texas Advance Directives Act (TADA). Its aim is to allow patients to make their care preferences known before they need care, and to protect patients from discomfort, pain, and suffering due to excessive medical intervention in the dying process. The time may come when all that can be done for a patient is to alleviate pain and suffering, and preserve the patient’s dignity. For physicians, this is about medical ethics and providing medically appropriate care.

 

Then-Gov. George W. Bush signed TADA into law in 1997. It had unanimous support from physicians, nurses, hospitals, nursing homes, hospice care facilities, and pro-life organizations. The law provides a balanced approach to addressing one of life’s most difficult decisions.

 

TADA allows a patient to issue an out-of-hospital do-not-resuscitate (DNR) order, a medical power of attorney, or a directive for physicians and family members regarding the person’s wishes to administer or withhold life-sustaining treatment in the event the person is in a terminal or irreversible condition and unable to make his or her wishes known. Additionally, when an attending physician morally disagrees with a health care or treatment decision made by or on behalf of a patient, the act provides for a process whereby an ethics or medical committee reviews the physician’s refusal. The patient is given life-sustaining treatment during the process. If the ethics committee decides that discontinuing lifesaving treatment is in the best interest of the patient, and the family disagrees with that decision, the hospital must continue treatment for 10 days to allow the family some time to find a different facility for the dying patient.

 

Legislation has been introduced in the past two legislative sessions that would instead require indefinite treatment.

 

TMA has opposed the proposed legislation because it would prolong unnecessary — and often painful — care. It would require physicians, nurses, and other health care professionals to provide medically inappropriate care, even if that care violates medical ethics or the standard of care. It also sets a dangerous precedent for the legislature to mandate the provision of physician services and treatments that may be medically inappropriate, outside the standard of care, or unethical.

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Make End-of-Life Care Better for Patients, Families, Physicians

Make End-of-Life Care Better for Patients, Families, Physicians | Healthy Vision 2020 | Scoop.it
From the beginning of life until the end — and for all the days in between — physicians are bound by our oath and professional Code of Ethics to put our patients first.
Texas Medical Association's insight:

Respect patients in their final days

 

Thanks to the advancements of medicine and science, Texans are living longer. However, these blessings bring the challenges of care and treatment decisions in life’s final stages. Advance directives allow patients to make their end-of-life treatment decisions known in the event they become incapable of communication or incompetent. Without advance directives, some of life’s most difficult decisions are being thrust upon unprepared adult children, parents, or other loved ones.

 

At each step, human beings are involved in both deciding on and providing treatment. We must respect the value of life and the moral conscience of those involved.

 

Texas physicians abide by the Code of Medical Ethics, which includes “First, do no harm.” For this reason, TMA supports the Texas Advance Directives Act (TADA). Its aim is to allow patients to make their care preferences known before they need care, and to protect patients from discomfort, pain, and suffering due to excessive medical intervention in the dying process. The time may come when all that can be done for a patient is to alleviate pain and suffering, and preserve the patient’s dignity. For physicians, this is about medical ethics and providing medically appropriate care.

more...
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Medical ink for #DNR?

Medical ink for #DNR? | Healthy Vision 2020 | Scoop.it

We certainly can't endorse the idea of doing it by tatoo -- but it is very important that people of all ages share their end-of-life wishes with their loved ones during a time of relatively good health.

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