This article provides an understanding of terms like general power of attorney, enduring power of attorney, advanced health care directive, and guardianship in the context of patient care.
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Table of Contents Contents 3 a) Understanding of the terms.......................................................................................................2 1.General power of attorney.............................................................................................2 2.Enduring power of attorney..........................................................................................2 3.Advanced health care directive.....................................................................................2 4.Guardianship.................................................................................................................2 b) The way each of the below term can affect patient care.............................................................2 1.General power of attorney.............................................................................................2 2.Enduring power of attorney..........................................................................................2 3.Advanced health care directive.....................................................................................3 4.Guardianship.................................................................................................................3 Q 4) Action in the situation provided in case study.........................................................................3 1
3 a) Understanding of the terms 1.General power of attorney General power of attorney may be defined as an organisation or individual, known as attorney in fact or agent, that has been provided powers in order to act on the behalf of another person. It provides broad authorisations to the agent and enable them to take legal and medical decisions or financial decisions. 2.Enduring power of attorney An enduring power of attorney is referred as legal agreement which allow an individual to appoint a trusted individual to make property or financial decisions on their behalf. 3.Advanced health care directive An advanced healthcare directive is a kind of legal document in which an individual specify what actions must be taken regarding their health if they are not able to take decision for themselves due to any kind of incapacity or illness. It is also known as personal directive, medical directive, living will or advance decision. 4.Guardianship Guardianship can be stated as an import tool use for protecting incapacitated adults who are not able to care for themselves. Their role is to help the individual with their decisions regarding healthcare, ranging from regular appointments to other serious surgical procedures as well as end of life decisions. b) The way each of the below term can affect patient care 1.General power of attorney For example - A patient can develop special power of attorney that only enable his spouse to take medical decisions on his behalf. This impacts effectively on the decision making regarding the treatment of the patient. 2.Enduring power of attorney For example - if a person is in very serious condition or suffering from chronic disease, then by developing an enduring power of attorney, he or she provides right to that trusted individual to take financial decisions on his or her behalf. 2
3.Advanced health care directive For example - this term can affect the care of patient as if this directive is developed by the patient, then no other individual will be able to take decisions regarding treatment on his or her behalf. 4.Guardianship For example - this impact on care of patient as due to this import toll, no other member except guardian will be able to take any kind of decisions regarding the patient ranging from regular appointments to end of the life decisions. Q 4) Action in the situation provided in case study In the provided case study, Mrs F was suffering from advanced bladder cancer along with urinary retention as well as pain score of 6 out of 10. In order to relieve her pain as well as urinary retention, it is required to insert indwelling catheter. The family of Mrs. F said that there is no need to talk to her regarding the procedure of insertion of catheter and they can make decisions on her behalf. However, she tries to ask the care provider about what is happening, grabbing her lower abdomen as well as crying. In this situation, it is very necessary for the healthcare provider to take ethical decision by considering the ethical principles involving principle of autonomy, justice, nonmaleficence, beneficence, confidentiality, rights and veracity. It is very much important to respect the culture of patient and treat her fairly. Personal information of the patient must be kept confidential and the health care provider requires to ensure that no personal information is shared to third party. At the time of providing care to Mrs. F, the principle of autonomy must be followed as it enables health care provider to respect as well as support the decision of patient to refuse or accept life-sustaining treatment. In case of Mrs. F, she has no information about the treatment so, it is important for care provider to make sure that she receives all the necessary information like complications, risks and benefits of treatment so that well informed decisions can be taken. Apart from this, use of nonmaleficence principle will help in accomplishing beneficial health outcomes for the patient by selecting interventions which because least amount of harm to Mrs. F. The principle of benefits can be applied in providing pain medication to the patient or by holding the hand of grieving family member. In addition to this, justice ethical principle enables healthcare provider in case of Mrs. F to ensure that care is provided on equal and fair basis, regardless of the financial and social status 3
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of patient. Moreover, telling the truth to Mrs. F and her family members must be important for care provider by following principle of veracity. Thus, by applying all these principles while providing care to Mrs. F, health care provider will enable to make ethical decisions regarding the treatment of patient and ensure attainment of effective health outcomes. 4