University Nursing Essay: Advance Care Planning and Ethical Issues

This nursing essay examines the use of Advance Care Planning (ACP) and Advance Care Directives (ACD) in Australia, arguing in favor of their implementation to improve end-of-life care. It discusses the significance of ACP, which assists individuals with healthcare information and decision-making, aligning with ethical principles like autonomy and beneficence. The essay highlights the benefits of ACP and ACD, including improved quality of death, patient and family satisfaction, and reduced unwanted hospital admissions, while acknowledging potential ethical dilemmas. It also explores how the Medical Treatment Act 1988, The Guardian and Administration Act 1986, The Powers of Attorney Act 2014 and The Charter of Human Rights and Responsibilities Act 2006 within Victoria's legal framework help to mitigate these issues, ensuring patient wishes are respected even when autonomy is lost. The conclusion emphasizes the benefits of ACP and ACD in providing adequate end-of-life care and overcoming ethical dilemmas, advocating for their continued use in Australia.

Running Head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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Introduction
With the increasing population of older adults, there is an increasing prevalence of
chronic disability. Many people lack the awareness on whom to communicate about the end of
life care. In response to this situation, advance care planning and directives has been developed
in Australia. The paper argues in favour of the use of Advance Care Planning (ACP) and
discusses ethical dilemma related to it. Ethical dilemma is a situation where one cannot reach a
solution in ethically acceptable fashion.
Significance to Advanced Care Planning & Directives
ACP is the national program that assists individual with resources and health care
information. With the help of the program, the individuals can make the health care decisions.
The care providers can know the preferences, values and beliefs of the client through ACP and
both together can plan for the future medical care. This program is based on the ethical principles
including autonomy, beneficence and non-maleficence. On the other hand, the advance care
directives or ACD is the written document that guides the future care of patients in the event they
are not able to directly involve in decision-making. ACP should be used in Australia for it has
many benefits (Mullick et al., 2013).
According to randomised control trial by Detering et al. (2010) ACP and ACD improves
the end of life care. It improves the quality of death as it considers the patient’s preferences and
respects their wishes. Thus, ACP allows both patient and family satisfaction with care. The
process reduces the likelihood of the patient to due in unwanted place or unwanted hospital
admissions. It reduces the depression, stress and anxiety in the surviving relatives.

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Ethical dilemma may occur to patients and the care providers when there is no one to
name as proxy or in case the family members may disagree with the patient’s wishes. Ethical
dilemma in ACP and ACD can be avoided by considering previously mentioned wishes and
preferences of patient even if currently losses the ability to be autonomous (Butler et al., 2014).
The ACP and ACD is implemented in within Vcitoria’s current legal framework through the
Medical Treatment Act 1988, The Guardian and Administration Act 1986, The Powers of
Attorney Act 2014 and The Charter of Human Rights and Responsibilities Act 2006. The first
ACT allows the person to accept or deny medical treatment as well as employ a substitute to
make decision. Similarly, the second ACT allows the patients to appoint an enduring guardian to
make decision on behalf of the patient. The third Act assist in new role of supportive attorney.
This act consolidates power of making financial decisions related to treatment. For people
making power of attorney, the Act increases legislative protections. The last ACT allows the
public authorities to act compatibly with and respect the human rights. Thus, this legislations
have reduced the ethical issues to a great extent (Flo et al., 2016).
Conclusion
It can be concluded that ACP and ACD are beneficial for the individuals to revive
adequate end of life care even if they lose autonomy. With the help of the legal framework and
the protection offered, it is easy to overcome the ethical dilemma. Hence, it should be used in
Australia.

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References
Butler, M., Ratner, E., McCreedy, E., Shippee, N., & Kane, R. L. (2014). Decision aids for
advance care planning: an overview of the state of the ScienceDecision aids for advance
care planning. Annals of internal medicine, 161(6), 408-418.
Detering, K. M., Hancock, A. D., Reade, M. C., & Silvester, W. (2010). The impact of advance
care planning on end of life care in elderly patients: randomised controlled
trial. Bmj, 340, c1345.
Flo, E., Husebo, B. S., Bruusgaard, P., Gjerberg, E., Thoresen, L., Lillemoen, L., & Pedersen, R.
(2016). A review of the implementation and research strategies of advance care planning
in nursing homes. BMC geriatrics, 16(1), 24.
Mullick, A., Martin, J., & Sallnow, L. (2013). Advance care planning. Bmj, 347(7930), 28-32.