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Challenges In Capacity & Decision Making

929 words - 4 pages

The common law provides each individual with legal rights to determine his or her own health-care (The National Conference of Commissioners on Uniform State Laws [NCC], 2014). In addition, an individual have the right to refuse treatment that would sustain life (NCC, 2014). The Model Health-Care Consent Act addressed the issue of consent to treatment, but does not address the problems of a patient who is dying (NCC, 2014). When a person lacks legal capacity, the issue is unclear and can be complex. The law in many states does not provide clear answers to the question of who may make health-care decisions for adults who lack legal capacity and have no designated guardian (NCC, 2014).
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Jones can comprehend, appreciate, and reason the contingencies of treatment or non-treatment (Duffy, 2010). If he is not able too, it is best to act in the patient’s best interest (Duffy, 2010). The patient must also be able to communicate his or her choices about their options for treatment or non-treatment. These factors play a role in consenting or validly rejecting medical treatments (Duffy, 2010). If the patient is determined to lack capacity, there are many alternatives as to who decides on behalf of the patient (NCC, 2014). The Uniform Health-Care Decisions Act states, “Any adult with capacity or emancipated minor may give an oral or written instruction to a health-care provider, which remains in force even after the individual loses capacity” (NCC, 2014, p.1). Health care decisions can either be made by an agent that was authorized by the adult via a written power of attorney or if there is a court appointed guardian (NCC, 2014). A guardian may make health-care decisions on behalf of the patient if there is no agent (NCC, 2014). If an individual is with legal capacity, s/he may select the surrogate, but if s/he chooses not to select a surrogate, then an individual related to him may step forward and assume the authority, in this case it would be his daughter. His daughter would then be considered a surrogate because she lives with him and is his caregiver (NCC, 2014).
In this case, a social worker comments that the daughter might be afraid of an elder-neglect investigation if her father dies. Thus, in this situation an ethics committee should be involved. When making medical decisions, patients, families, and staff may have difficult choices to make. Therefore, meeting with the ethics committee and discussing the issues at hand can be helpful and reassuring when a difficult decision must be made (Michigan Health System [MHS], 2014). Ethics committee can help...

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