Legal and
Ethical Dilemmas

Learning Objectives

Upon completing the course you'll be able to:

Chapter 1. Test Your Sleep I.Q.

After completing this course you will be able to:

Chapter 1: Advance Directives and End-of-Life Decisions

  1. Explain two kinds of advanced directives: Living Wills, Durable Power of Attorney for Health Care.

  2. Explain patient self determination act and describe the responsibilities of a health care provider under it.

  3. Explain why anyone would need an advanced directive.

  4. Describe two benefits of appointing a health care agent.

  5. Describe two things one should do to ensure that his or her advanced directives will be honored.

  6. Distinguish between a will, a living trust, and a living will.

  7. Distinguish between a power of attorney and a durable power of attorney and a durable power of attorney for health care.

Chapter 2: Durable Power of Attorney or Living Will?

  1. Durable power of attorney or living Will?

  2. Explain the uses and respective advantages and disadvantages of a Durable Power of Attorney and a Living Will.

  3. List 6 duties of the Attorney-in-Fact.

  4. Explain "spring" Durable Power of Attorney.

Chapter 3: Common Misconceptions

12. Discuss with a patient at least 6 common misconceptions concerning advanced directives.

Chapter 4: Medical Treatments and your Advanced Directives

13. Explain the following medical treatments:

Life support
Cardiopulmonary resuscitation (CPR)
Mechanical ventilation
Artificial nutrition and hydration
Kidney Dialysis
Other medical treatments, such as surgical procedures, diagnostic studies, antibiotics, blood transfusion, chemotherapy and radiation therapy.

14. Formulate a values questionnaire to assist individuals upon end of life treatment decisions.

Chapter 5: Artificial Nutrition and Hydration

15. Define artificial nutrition and hydration.

16. Distinguish artificial nutrition and hydration from ordinary eating and drinking.

17. Explain the consequences of the withdrawal of artificial nutrition and hydration.

  1. List 7 considerations which will help an individual in making decisions about the use of artificial nutrition and hydration.

Chapter 6: CPR, DNR and End-of-Life Decisions

19. Explain what a DNR is, and discuss its application with a patient.

20. Distinguish between a hospital and non-hospital DNR orders.

21. Discuss 7 guidelines for the appropriate use of DNR orders.

Chapter 7: Dying at Home

22. List 3 advantages of dying at home.

23. Define hospice.

24. Discuss legal considerations concerning dying at home decisions.

Chapter 8: Ethics Committees and End-of-Life decisions

25. Discuss the role of ethics committees and patients right to make end-of-life decisions.

Chapter 9: Third Parties - Can They Take Away Your Rights?

26. Discuss the legal standing of third parties intervening with a persons end of life decision.

Chapter 10: Enforcing the Right to Refuse Treatment

  1. Discuss the two case studies laid out in this chapter and a patients family or friends outline various steps a patients family or friends should take to enforce his or her right to refuse treatment.

Chapter 11: Oregons assisted Suicide Law

28. Discuss various provisions and implications of Oregons Assisted Suicide Law.

Chapter 12: Organ Donation

29. Discuss the need for Organ Donation and provisions of the Uniform Anatomical Gift Act (UAGA).

Evaluation of Individual Objectives

To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.
Course Outline

Chapter 1: Advance Directives and End-of-Life Decisions
Advance directives
Patient self-determination act
Durable power of attorney for health care
Living will and also appoint an agent
Benefits of appointing a health care agent
Benefits of having a living will
Preparing the Forms
The Witness
Complete advance directives
Medical Treatment and Your Advances Directives
Life-sustaining treatments
Learn the Benefits and Burdens of different medical treatments
Refusing a life support
Difference between an artificial nutrition (tube feeding) and hydration
Other Questions
When to stop medical treatment.
When a health care provider won't honor an advance directive
Federal law on advance directives
The difference between a "Will" and "Living Trust"
The difference between a "Power of Attorney" and "Durable Power of Attorney"

Chapter 2: Durable Power of Attorney or Living Will

Duties of the attorney-in-fact
Successor attorneys-in-fact
Compensation of the agent
Statuary language
Advantages of a "springing" power
Determination of disability

Chapter 3: Common Misconceptions

Signing an Advance Directive
The Effect of State Law
Restrictions on tube feeding and hydration
The rules for appointing a health-care agent
Medical Conditions and Treatments Not Specifically Covered by the Statue
Restrictions on Tube Feeding and Hydrations
Appointing a health care agent

Chapter 4: Medical Treatments and Your Advances Directives

Life Support
Cardiopulmonary resuscitation (CPR)
Kidney Dialysis
Discuss medical treatment with a doctor
Pain management
Stopping a medical treatment
Values Questionnaire
Overall attitude toward life
Thoughts about independence and control
Overall attitude toward health
Attitude toward illness, dying and death
Perception of your doctor & other caregivers
Personal relationship
Religious background and relief

Chapter 5: Artificial Nutrition And Hydration

Artificial nutrition and hydration
Side effects from artificial nutrition and hydration
Artificial nutrition and hydration different from ordinary eating and drinking
Withdrawal of artificial nutrition and hydration
Appropriate to give artificial nutrition and hydration
Advantages on refusing nutrition
Laws abut artificial and hydration
Stopping an artificial nutrition and hydration
A doctor insisting on providing artificial nutrition and hydration
Refusing artificial nutrition and hydration
Life insurance policies affecting life sustaining treatments
Medical community on ethically permissible to stop artificial nutrition and hydration
Nursing homes and hospital agree on stopping artificial and hydration
Use of artificial and hydration

Chapter 6: CPR, DNR and End-of-Life Decisions Cardiopulmonary Resuscitation

Someone refusing a CPR
Do-not-resuscitate order
DNR order
Instructions in a living will enable a person to avoid CPR
DNR orders governed by the law
Consenting to a DNR order
Discussing a DNR order with a physician
Questions to ask about DNR to a physician
Revoking a DNR order
Non-hospital Do-Not-Resuscitate order
A hospital DNR order
A non-hospital DNR orders
Living will or medical power of attorney be honored by EMS personnel
Non-hospital DNR orders governed by state law
Revoking a non-hospital DNR orders
Discussion of Legal and Ethical Issues
Guidelines for the Appropriate Use of Do-Not-Resuscitate Orders

Chapter 7: Dying At Home

A person right to die at home
Advantage to die at home
Disadvantages to die at home
Medical Considerations
A doctor's role when a patient is dying at home
Difference between a home health care and hospice
Legal Considerations
Cost of hospice or home health care
Hospital responsibilities toward a person who has decided to die at home
Families member legal risk allowing a loved ones to die in their homes
Person dying at home changed his or her mind
When the Dying Person Is In the Hospital
How to prepare a dying person's discharge
When the Dying Person Is At Home
How to prepare for their love one's death
Advance Directives
Non-hospital DNR order
Preventing unwanted hospitalization
Stopping medical treatment at home without the doctor's knowledge
Family risk for proving too much pain medication
Supporting a loved one throughout the dying process
Support for the family
How to know when a loved one is near to death
After Death
How to make sure that their loved one is dead
Who to call after the death
Calling 911 after the person's death
Signing the death certificate

Chapter 8: Ethics Committees and End-Of-Life Decisions

The Ethics Committee of Harbor Hospital Center Cautions

Chapter 9: Third Parties Can They Take Away Your Rights

Third-Party Intervention and the Law
Chapter 10: Enforcing The Right To Refuse Treatment
To Honor a Living Will
Getting A Court Order

Chapter 11: Oregon's Assisted Suicide Law

The Oregon Death Dignity Act Allow

Chapter 12: Organ Donation

Considering an organ donor
Laws that govern organ donation
Advance directives to donate organs
Conflict existing between an advance directives and donating an organ

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