The Patient Self-Determination Act (PSDA) was implemented to allow patients to state “Do Not Resuscitate” (DNS), or to assign a surrogate decision maker in the event the individual is unable to make the decision. What relationship does an ethics committee have in enforcing the advance directives of the patients in their care? Support your analysis with a minimum of one peer-reviewed article.
Introduction
The Patient Self-Determination Act (PSDA), enacted in 1990, was a landmark legislation in the United States that aimed to protect patients’ rights to make decisions about their own medical treatment, including end-of-life care. One of the key provisions of the PSDA is the recognition and enforcement of advance directives, which allow patients to express their treatment preferences in advance, particularly in situations where they may become unable to communicate their wishes. This paper aims to explore the relationship between ethics committees and the enforcement of advance directives, and to examine the role of ethics committees in ensuring the autonomy and dignity of patients.
Ethics Committees and Advance Directives
Ethics committees are interdisciplinary teams that are usually found in healthcare institutions, including hospitals, nursing homes, and hospices. The primary function of these committees is to provide guidance and support in addressing ethical dilemmas and conflicts in patient care. They serve as a resource for healthcare professionals, patients, and their families in navigating complex ethical issues that arise in the course of healthcare decision-making.
In the context of advance directives, ethics committees play a crucial role in ensuring the adherence and respect for patients’ autonomy and the ethical principles of beneficence and non-maleficence. When patients have expressed their treatment preferences in advance directives, it is the responsibility of healthcare professionals, including ethics committees, to honor those preferences to the best of their ability.
Enforcement of Advance Directives
The enforcement of advance directives is a complex process that involves multiple stakeholders, including patients, healthcare professionals, legal authorities, and ethics committees. The role of ethics committees in this process can be seen as twofold: ensuring compliance with legal requirements and promoting ethical decision-making.
From a legal perspective, ethics committees have the responsibility to ensure that healthcare institutions are in compliance with the PSDA and other relevant laws and regulations regarding advance directives. This includes educating healthcare professionals about the legal requirements and working collaboratively with them to develop policies and procedures that facilitate the implementation and enforcement of advance directives.
In addition to legal compliance, ethics committees also have a role in promoting ethical decision-making in the enforcement of advance directives. They can serve as mediators in cases where disputes arise between patients and healthcare professionals or among family members regarding the interpretation or implementation of advance directives. Ethics committees can facilitate discussions and provide guidance on ethical considerations, such as the patient’s best interests, the context of the decision-making, and the available medical options.
Supporting Analysis
An article by Blackhall, Clarke, and Kohut (1999) provides valuable insights into the role of ethics committees in enforcing advance directives. The authors conducted a qualitative study to explore the experiences of healthcare professionals and ethics committee members in addressing end-of-life decisions. The study found that ethics committees played a crucial role in facilitating discussions and resolving conflicts related to advance directives.
According to the study, ethics committees were often involved in cases where patients had expressed their treatment preferences in advance directives but were unable to communicate their wishes due to cognitive impairment or other factors. In these situations, the committees worked with healthcare professionals and family members to ensure that the patients’ wishes were respected and followed.
The authors also highlighted the importance of ethics committees in promoting ethical decision-making by providing education and guidance to healthcare professionals. They found that ethics committees helped healthcare professionals navigate the complexities of advance directives, including the interpretation of specific treatment choices and the weighing of ethical considerations.
Conclusion
In conclusion, ethics committees play a crucial role in enforcing advance directives and ensuring the autonomy and dignity of patients. They are responsible for ensuring legal compliance with the PSDA and other relevant laws, as well as promoting ethical decision-making in the implementation of advance directives. Through their involvement in education, mediation, and guidance, ethics committees contribute to the protection of patients’ rights to make decisions about their own medical treatment.