These are health care decisions made by a person on what he/she would like to be done to in case he/ she becomes incompetent at some time in future. Decision making on health care issues is not easy and people are advised to seek advice from so many medical professionals in order to make the right kind of decision. It is not only a person’s doctor who should give directions on what to do then conclusions made from there, more information can be obtained from other health care professionals to help the person make satisfactory decisions on what he/she wants (Monagle and Thomasma 2004: 141).
Advanced directives are made when one is mentally competent and are made on different forms as will be discussed. Different patients suffer different illnesses or diseases and there are various cases of emergency. Most cases that do occur are those of cardiac problems, respiratory and life sustaining problems. Advance directives indicate what a person would like to be done to in case he/she can no longer make his/her own decisions (Monagle and Thomasma 2004: 141).
A person is also allowed to assign this decision making role to a physician he/she trusts and knows his/her health status, therefore can make appropriate decisions. Advanced directives as have been indicated, apply in different sections of healthy care. Different health care departments have to abide by the advanced directives of the patients. Almost all health care departments receive these advanced directives on what a patient would like to be done to. An example is the emergency department that deals with resuscitation of patients with heart problems, respiratory problems among others (Bledsoe et al, 2008: 156).
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The paramedics in this department in most cases do not have the time to read and analyse the advanced directives written by the patient and the advanced directive may not even be available at the time of emergency. They are always fighting to save the life of the patient at the time of emergency as their protocols dictate, giving them a hard time in consideration to advance directives documentation as well as information retrieval about the advanced directives.
They therefore have problems with the advance directive system and forms. Some countries or hospitals have developed different forms of advanced directives that suit the emergency department as well as other medical departments (Bledsoe et al, 2008: 157). This will be discussed later. The different forms of legal advanced directives are not known to so many people and so they do not know which one to use when in need of an advanced directive.
Every adult in a mentally competent state is allowed to make a decision and write an advance directive. It does not mean that if one does not have an advance directive then the person will not be treated or offered health care services, this is an optional measure just meant to give people a decent death or health care service of choice. It is not only the people with terminal cases that write advanced directives. Normal people who feel that accidents can occur to them and may need specific medical treatment write advanced directives indicating what they want and what they do not want when such a situation occurs (Cotts 2006: 5).
This may be a problem though since the person at the time of decision making, do not know how the accident will occur or how his life will be affected after the accident. It is only after the accident that the real facts can be revealed to the person. This always causes problems with the close relatives to the incapacitated person. Most cases of advance directive are on those with terminal illnesses who know that their life will not be good after some period of time and therefore make decisions on their life when they are fully competent (Cotts 2006: 5).
... . In very few cases did advance directives have any influence over decisions to withdraw or withhold life prolonging treatment. The ... right to refuse medical treatment. People can put anything in their advance directives. Some people list every medical intervention they do ... With these advances it has become possible to keep people in a vegetative state for almost unlimited periods of time. Moreover ...
People always make decisions not to be put into any life sustaining machines, not to be resuscitated or allow themselves to be treated so that there lives can be sustained. An advance directive is just a guideline to a doctor on what the patient wants to be done to in cases of incapability. An example of an advance directive is the Do Not Resuscitate, which dictates that a doctor should not resuscitate a patient in case of heart failure, or respiratory problem that makes the person not able to breath (Atkinson 2006: 46).
There are different types of advanced directives. These are anatomical donation, a living will and a health care surrogate designation. There is a different form in case of emergency medical care. If someone does not want any resuscitation in case of respiratory or cardiac rest, then a form of advanced directive known as the DNR (Do Not Resuscitate) is used. All these types have specific areas of use (Atkinson 2006: 46).