Advance Care Practice and Patient Autonomy

Running head: ADVANCE CARE PRACTICE AND PATIENT AUTONOMY
Advance Care Practice and Patient Autonomy
Name
Institutional Affiliation

ADVANCE CARE PRACTICE AND PATIENT AUTONOMY 2
Advance Care Practice and Patient Autonomy
End of life care is a crucial aspect of palliative care, but it can be physically and
emotionally effective in relieving pain in patients if it entails the wishes and preferences of the
patient. Advance Care Planning (ACP) plays a significant role in making sure that the
preferences and goals of the patient are fulfilled even when the patient cannot make decisions.
Patient autonomy has become one of the contested topics in the recent past, especially as chronic
diseases become prevalent. Patient autonomy refers to the moral right of a mentally-stable person
to choose what to do and how they want it to be done in case they lose the capacity to make
decisions in future. The Australian government passed the Advance Care Planning legislation in
2016 and this law has redefined the understanding of patient autonomy in the health care
practice. There has been significant concern over the autonomy of patients when it comes to
making decisions regarding their future health. In view of this understanding, this paper
discusses the case scenario of Melissa, a thirty-seven-year-old woman diagnosed with stage 4
bowel cancer. The paper argues that the Melissa has a moral right to determine the time and the
place where she would wish to die through advance care planning.
Advance Care Planning in Relation to Melissa’s Case Scenario
Advance care planning is defined by the Australian Government Department of Health as
the right for a person to determine who will speak for them in future in case they become unwell
and unable to communicate their preferences (Advance Care Planning Australia, 2019).
According to Health.vic (2019), the Medical Treatment Planning and Decisions Act 2016
stipulates clear obligations for all healthcare practitioners handling patients incapacitated in
making decisions. This legislation gives Australians an assurance that their health care
preference and ambitions will be respected even when they lose their ability to make decisions.

ADVANCE CARE PRACTICE AND PATIENT AUTONOMY 3
Even though Advance care planning (ACP) is commonly associated with old, frail, and people
with chronic diseases, it also applies to healthy people who are concerned about their health and
their future preferences regarding medical care. The purpose of ACP is to give patients
autonomy to make decisions that align with their preferences, goals, and beliefs in future. This
understanding applies to Melissa’s case, considering that there are different stakeholders who
may want to make decisions regarding her health. The decisions they make may not be in line
with her goals and beliefs.
Melissa’s health status requires that she prepares for her future death through ACP. Since
is in stage 4 of bowel cancer and she may need palliative care in future, it is necessary that she
makes early decisions that are consistent with her preferences. This will save the family from
future costs and expenses that may affect her family. According to the case study, Melissa
separated from her husband more than ten years ago and has been living with her two children.
Her parents are both aged and have chronic problems while her husband’s parents are estranged
after Melissa broke up with their son. Daniel, her ex-husband has re-partnered and lives in
Melbourne. Melissa is worried of the future of her two children aged twelve and fifteen. She
knows that death is inevitable and has to decide the place to die and the time of her death.
Melissa could consider dying in Queensland near her parents, even though they are aged
and have chronic problems. She could also choose euthanasia as her preferred method of dying
in case she loses her ability to make decisions in future. These decisions will be economical both
for Melissa and the remaining family members. According to Bond, Kim, Franciskovich,
Weinberg, and Asche (2018), ACP through advance directive documentation is accountable for
patient satisfaction and decreased medical costs in palliative care. The decision to die in
Queensland will be satisfactory for her aged parents who cannot manage to travel to Victoria. As