What is the role of the doctors in deciding whether or not to respect Mr. Gomez’s advanced directive?.
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What is the role of the doctors in deciding whether or not to respect Mr. Gomez’s advanced directive?
Although advance directives provide a legal basis for physicians to carry out treatment using a health care proxy which in this case is Elena, they also should reflect the patient’s values and preferences. The physician is in a position where he should integrate medical knowledge together with Mr. Gomez’s individual values, and cultural influences into his end-of-life care. The doctor should respect the autonomy of Mr. Gomez decision of not having dialysis and only perform tube feedings until he eventually passes away. Advance directives are legal document that must be respected by all healthcare professionals (O’Sullivan et.al 2016).
Does Mr. Gomez’s estranged wife have the authority to step in and ignore Mr. Gomez’s advanced directive. Explain your reasoning while providing evidence-based solutions in your conclusion
Mr. Gomez estranged wife has no authority to question any decisions made concerning his care because he has a healthcare proxy which is his daughter Elena. Based on the fact that this legal document exists, Mrs. Gomez, Elena’s mother cannot alter any decisions made by her daughter. Physicians and all healthcare professionals are mandated to follow and respect such documents and be advocates for the patient in the time of dilemma between family members. Mr. Gomez appointed his daughter as a proxy because he trusts that she will make sound decisions and respect his wishes in the event he cannot do so for himself. According to Lipkin in his article, he states that many patients avoid talking about healthcare proxy until it is brought up by their physicians. Physicians are encouraging families to have such conversation and designate a proxy that they trust and understand their wishes (Lipkin, 2016).
Gomez’s estranged wife has filed temporary order to ignore the advanced directive. If you were Elena, how would you handle this dilemma? What rights does Elena have that allow her to honor her father’s wishes?
Elena has the right to honor her father’s wishes because she is his healthcare proxy and she has full understanding of what her father wants. Even if she does not agree with her father’s decision of not wanting dialysis, she is mandated to respect those wishes and advocate for her father to get the exact care he wishes for. Also, if I was Elena, I will try to have a conversation with my mother and educate her more on advance directives and what they really mean in situations like this. She can also request counselling for both of them with the hospital ethical committee.
What is the role of the ethics committee and how can they best support the client and his family?
The ethical committee is there to perform the following;
-Educating healthcare professionals about ethical principles.
-Consultation for decision making for health care professionals.
-Consultation for decision making for family.
-Developing organizational policies.
The ethic committee can support the client and his family by educating them about the situation and helping them make appropriate decisions.
Lipkin K. M. (2016). Brief report: identifying a proxy for health care as part of routine medical inquiry. Journal of general internal medicine, 21(11), 1188–1191. https://doi.org/10.1111/j.1525-1497.2006.00570.x
O’Sullivan, R., Mailo, K., Angeles, R., & Agarwal, G. (2016). Advance directives: survey of primary care patients. Canadian family physician Medecin de famille canadien, 61(4), 353–356.