Introduction
I got the advanced directive by finding it in the templates on the health care site, and different people can also find it in areas where the state distributes the advanced directive. Each directive, according to the rules, complies strictly with state law. For example, the government carried out terminal euthanasia in only eight states; people need documents such as the advanced directives to understand it. Modern medicine cannot contradict current legislation and local rules since doctors are responsible for the well-being and life of many patients, residents of the state.
While it has been difficult to find case studies in recent years based on state-specific studies of advanced directives and their benefits, many studies generally demonstrate the help of these documents. Doctors generally point out that this is a great way to communicate with patients and share the responsibility for complex treatment with them. The advanced guidelines are also helpful for relatives of patients who also need an explanation of the treatment.
The advanced directive is not easy to fill out, but I think it is exciting and valuable from an ethical point of view. When filling out, the patient must understand the whole responsibility assigned to the hospital and doctors and realize that many of the problems doctors face are not physical difficulties but ethical ones. It is also necessary to understand that the patient and the doctor are establishing communication (Fujimori, 2017, p. 1623). Completing an advanced guideline can be time-consuming and may not be tolerated by patients with acute pain or general medical condition.
Physician Orders for Life-Sustaining Treatment (POLST) Form
POLST is a form where data on diagnoses, past illnesses, and the patient’s state of health are entered. This form contains recommendations for examination, medications taken, and transferred procedures or operations. This information is beneficial when traveling or moving and in situations where doctors in new hospitals do not have time to review the medical history in detail or conduct a detailed examination of the body.
Patients cannot fill out the POLST, as their signature does not verify the POLST. Usually, a social worker or doctor (sometimes a nurse) interviews a patient (often older people or people with disabilities; statistical studies in this area show that over 70% of people with POLST are more aging people) and enter the data into the form (Vranas et al., 2021). The record contains information about the desired treatment and complaints. The document is considered valid only under the signature of a doctor.
It is also vital that the POLST contains all the patient’s contraindications, many in people with disabilities or the elderly. The availability of detailed information on contraindications (medications, loads, and procedures) helps doctors quickly and efficiently make decisions about the treatment and monitoring of patients. For filling out the POLST, a detailed patient interview by a doctor or a person who has undergone special training is needed. In no case can the POLST be filled in by the relatives of patients or patients, even if it seems to them that they know their feelings well. Doctors, nurses, or social workers should review POLST periodically, usually when changing hospitals, if the patient’s condition is not critical. There are no fixed deadlines for revising the POLST since very different patients use this form for various reasons.
Although the POLST is an in-hospital document filled out personally by the doctor in direct contact with the patient, a notary must fill this form. In different states, the number of witnesses varies from one to two, but notarization remains unchanged. Unfortunately, people should remember that the patient’s family does not have the right to regulate or cancel the POLST prescriptions. It is a legal fact that patients must observe; therefore, discussing possible problems with your doctor is necessary to avoid unpleasant situations. Most social workers and nurses always recommend that patients and their families contact the doctor constantly.
Conclusion
The POLST and the advanced directive are valuable documents that improve the quality of care and increase patient responsibility. These forms allow doctors to work efficiently and ethically with even the most challenging patients. These documents should work together, complementing each other. The advanced directive is a legal document; POLST is a medical one, although lawyers must notarize it. The advanced directive is available to all United States citizens beyond the age of majority. POLST is available only for seriously ill people or the elderly. Patients can complete the extended directive independently, but the POLST is always carefully completed by a doctor, nurse, social worker, or POLST trained person. These essential documents are created due to a half-value conversation between doctor and patient. In addition, writing such forms increases trust in hospitals and doctors. These documents describe the desired treatment and the prohibitions that may and may not be known to new doctors unfamiliar with the patient, his (or her) family, and his long medical history. However, POLST warns of emergencies and teaches doctors to cope with them under the capabilities of the ill person’s body.
References
Fujimori, M. (2017). Advanced Directives — Are They Useful?. Journal of Thoracic Oncology, 12(11), 1622-1623.
Vranas, K. C., Plinke, W., Bourne, D., Kansagara, D., Lee, R. Y., Kross, E. K., Slatore, C. G., & Sullivan, D. R. (2021). The influence of POLST on treatment intensity at the end of life: A systematic review.Journal of the American Geriatrics Society. Published.