Note: Before completing this Discussion, please familiarize yourself with the Week 4 Discussion 1 Rubric located in the Course Information area of the course navigation menu.

The term advance directive refers to several different types of legal documents that may be used by a patient, while competent, to record future wishes in the event the patient lacks decision-making capacity. The choice and meaning of specific advance directive terminology depends on state law. An advance directive or health care directive may combine the functions of a living will and durable power of attorney for health care into one document in one state, but may be equivalent to a living will in another state.

Through advance directives, individuals can communicate to family members and health care providers what treatment options they find acceptable or unacceptable should they become unable to make these decisions later on. As useful as these documents are, they are not always well understood by the public.

For this Discussion, you will interview someone who has not yet completed an advance directive regarding end-of-life planning. Be prepared to explain the purpose and benefit of an advance directive document. You can find your own state’s laws by going to the CaringInfo website listed in the Learning Resources.

To prepare for this Discussion, review the description of advance directives in this week’s Learning Resources. Using the National Hospice and Palliative Care Organization website, download and print an advance directive form that is valid in your state.

Identify an individual you can interview in person about advance directives. This may be a friend, family member, or other acquaintance that has not yet completed an advance directive form.

Sit down with this person, and invite him or her to read the form and consider completing it. It does not matter whether the person actually does so or not. Take notes on any questions the person asks, whether he or she understands the purpose of the form, whether the person thinks the form is a useful way of dealing with future health care issues, and other key points and concerns expressed during the interview.

Post by Day 3 an analysis ofthe ways in which an advance directive might support a patient’s legal and ethical rights. Considering the interview you conducted, describe any questions, comments, or concerns your interviewee expressed regarding how an advance directive supports their legal and ethical rights.

Then, evaluate the impact an advance directive might have on end-of-life care from the perspective of health care providers and organizations. Apply ACHE policy for end-of-life planning for patients.

General Guidance on Discussion Posts: Your original post, due by Day 3, will typically be 3–4 paragraphs in length as a general expectation/estimate. Refer to the Week 4 Discussion 1 Rubric for grading elements and criteria. Your Instructor will use the rubric to assess your work.

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  ADAM Health Solutions. (n.d.). Mental status testing: MedlinePlus Medical Encyclopedia. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/003326.htm

• Torke, A. M., Sachs, G. A., Helft, P. R., Montz, K., Hui, S. L., Slaven, J. E., & Callahan, C. M. (2014). Scope and outcomes of surrogate decision making among hospitalized older adults. JAMA Internal Medicine, 174(3), 370–377.

  Scope and Outcomes of Surrogate Decision Making Among Hospitalized Older Adults by Torke, A.; Sachs, G.; Helft, P.; Montz, K.; Hui, S.; Slaven, J.; Callahan, C., in JAMA Internal Medicine, Vol. 174/Issue 3. Copyright 2014 by American Medical Association. Reprinted by permission of American Medical Association via the Copyright Clearance Center.

• Watson, A., Sheridan, B., Rodriguez, M., & Seifi, A. (2015). Biologically-related or emotionally-connected: Who would be the better surrogate decision-maker? Medicine, Health Care, and Philosophy, 18(1), 147–148.

  Biologically-related or Emotionally-connected: Who Would be the Better Surrogate Decision-maker?  by Watson, A.; Sheridan, B.; Rodriguez, M.; Seifi, A., in Medicine, Health Care, and Philosophy, Vol. 18/Issue 1. Copyright 2015 by Kluwer Academic Publishers – Dordrecht. Reprinted by permission of Kluwer Academic Publishers – Dordrecht via the Copyright Clearance Center.

• U.S. Department of Health and Human Services. (n.d.). Summary of the HIPAA privacy rule. Retrieved from http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html
• ACHE. (1994/2014). Decisions near the end of life. Retrieved from http://www.ache.org/policy/endoflif.cfm

  ACHE Policy Statement: Decisions Near the End of Life by N.D., in ACHE’s Leadership Online. Copyright 1994 by American College of Healthcare Executives. Reprinted by permission of American College of Healthcare Executives via the Copyright Clearance Center.

• American Medical Association. (1997). Medical futility in end-of-life care. JAMA, 281(14), 937–941.

  Medical Futility in End-of-life Care: Report of the Council on Ethical and Judicial Affairs by Halevy A.; Brody B., in JAMA, Vol. 282/Issue 14. Copyright 1997 by American Medical Association. Reprinted by permission of American Medical Association via the Copyright Clearance Center.

  Note: The AMA offered this opinion piece on medical futility in 1996, and it has been unchanged since.

• CaringInfo. (n.d.). Download your state’s advance directives. Retrieved from http://www.caringinfo.org/stateaIDownload