Medical Law & Ethics Week 5 Ethical Issues & Aging 2024 PDF

“Where Education Comes To Life” Course: Medical Law & Ethics Week: 5 Ethical Issues and the Aging What is the impact of an aging population on healthcare in the United States? Impact of Aging on Healthcare “Where Education Comes To Life”  Baby Boomer Generation O Individuals born b...

“Where Education Comes To Life” Course: Medical Law & Ethics Week: 5 Ethical Issues and the Aging What is the impact of an aging population on healthcare in the United States? Impact of Aging on Healthcare “Where Education Comes To Life”  Baby Boomer Generation O Individuals born between 1946 – 1965 (after WWII) O Characteristics that affect health care and Mas O Had fewer children or had them later is life. O How does this affect health care? O Anxiety increases because they are caring for older parent/younger child because of the delay of having children. O Economic hardships/advanced aging/health deterioration O Increased demand on resources O Health care O Prescription drug assistance “Where Education Comes To Life”  What is the answer to the increased demand on healthcare by this aging population? O Decrease care? O Decrease the amount that Medicare/Medicaid pays? O Mercy death? O Make families responsible for their aging family? What are the legal issues that could arise from this issue? “Where Education Comes To Life” Eliminate Legal Action by Effective Communication “Where Education Comes To Life” Geriatric Communication Considerations “Where Education Comes To Life” Legal Actions in Relationship to Mental Changes Aging and healthcare “Where Education Comes To Life” Mental Status of the Aging “Where Education Comes To Life” Legal Considerations “Where Education Comes To Life” Legal Considerations “Where Education Comes To Life” Legal Considerations “Where Education Comes To Life”  Legal and Medical Decisions O Advance Directives O MA should understand the basic function of advance directives and do not resuscitate (DNR) orders “Where Education Comes To Life” Legal and Medical Decisions “Where Education Comes To Life”  Legal and Medical Decisions O DOPA O Document in which the patient names a person or representative to make decisions regarding his or her health care when the patient is unable to do so. O Patients and family members need to specify which directives they wish to choose if the patient degrades into a persistent vegetative state. “Where Education Comes To Life”  Legal and Medical Decisions O Besides resuscitation, other directives include: O Withholding medication, with the exception of pain relief O Withholding food and hydration, particularly if nutrition is the only factor that would keep the patient alive O Desire for organ donation O Desire for autopsy “Where Education Comes To Life” Legal and Medical Decisions “Where Education Comes To Life” Legal and Medical Decisions “Where Education Comes To Life”  Elder Abuse “Where Education Comes To Life”  Elder Abuse “Where Education Comes To Life”  Elder Abuse O Organizations such as the National Center of Elder Abuse, American Association of Retired Persons, and state agencies on aging provide information on abuse. “Where Education Comes To Life”  Elder Abuse O What could be the consequences of reporting elder abuse for families? O Can a medical facility be sued if abuse is wrongfully reported? “Where Education Comes To Life”  Discussion O A geriatric patient comes to the front desk and has bruises, will not look you in the eye and the caregiver answers all questions. O How would you handle this situation? “Where Education Comes To Life”  Discussion – Points to Consider O First, follow the office policy and procedure. O Alert the clinical staff and physician. O If possible speak to the patient alone. O Be prepared to report the suspected or known abuse. “Where Education Comes To Life” DPOA, Living will, and DNR “Where Education Comes To Life” Ethics Versus Law Ethical Considerations “Where Education Comes To Life”  Real World Scenarios O A young man in your practice lost his mother to Huntington's Chorea, an incurable neurological disorder that carries a 50% risk of transmission to children. Although he has no other physical complaints, he struggles with depression and anxiety and self-medicates with alcohol. He has made it known that should he be diagnosed with Huntington's, he prefers to die immediately rather than live with the diagnosis. O The patient's worst fears came true when two neurologists independently confirmed the diagnosis of Huntington's. O His next step was to visit a psychiatrist to request assistance with suicide. O The physician refused, after which the patient convinced the physician that he had no plans to commit suicide by himself. O At home, the young man wrote a suicide note explaining his choice, pinned it to his shirt and deliberately overdosed on antidepressants. When his wife discovered him unconscious she had him rushed to the hospital, the note still pinned to his shirt. http://www.medicalassistantcertification.org/medical-ethics/ “Where Education Comes To Life” Considerations http://www.medicalassistantcertification.org/medical-ethics/ “Where Education Comes To Life”  Real World Scenarios O Your patient is a 26-year-old girl who was diagnosed with Crohn's disease in her early teens. Crohn's is incurable, but can be managed with medication and good lifestyle choices. Untreated Crohn's can lead to permanent damage that requires surgical intervention, so it is in the patient's best interest to keep the illness in remission. Your patient's symptoms have been controlled until recently. Having graduated from college, she has lost the insurance coverage on her parents' policy that was afforded to her as an undergraduate. O A busy schedule has made it difficult for your patient to manage her illness with diet and exercise, and financial constraints have limited her access to medication. Her symptoms have worsened significantly within the last year, and most recently she has developed kidney stones so large that she is unable to pass them independently. When she stopped eating and drinking, her friends stepped in and delivered her to the emergency room. Her poor health required five days of inpatient treatment to stabilize. Your next best step is to surgically remove the kidney stones; however, your patient lacks the funds to pay for surgery and additional hospitalization. She leaves the hospital against medical advice. http://www.medicalassistantcertification.org/medical-ethics/ “Where Education Comes To Life” Considerations http://www.medicalassistantcertification.org/medical-ethics/ “Where Education Comes To Life”  Real World Scenarios Lynn, J., et. al. “The Ethics of Using Quality Improvement Methods in Health Care.” Annals of Internal Medicine. Vol. 146, Issue 9: 666- 673. 2007). O Some of the specific ethical standards that have been proposed for all quality improvement activities include: O social or scientific value from the quality improvement activity; O scientifically valid methodology; O fair participant selection to achieve a fair distribution of burdens and benefits; O favorable risk-benefit, limiting risks and maximizing benefits; O respect for participants by respecting privacy and confidentiality; O informed consent in minimal risk quality improvement activities as part of a patient’s consent for treatment; O and independent review of the ethical conduct and accountability of the quality improvement activity http://www.ache.org/ABT_ACHE/EthicsToo lkit/JA08_Ethics_Nelson_Gardent.pdf “Where Education Comes To Life”  Considerations O What do each of these mean to you? O social or scientific value from the quality improvement activity; O scientifically valid methodology; O fair participant selection to achieve a fair distribution of burdens and benefits; O favorable risk-benefit, limiting risks, and maximizing benefits; O respect for participants by respecting privacy and confidentiality; O independent review of the ethical conduct and accountability of the quality improvement activity “Where Education Comes To Life”  Practice Practice Practice O What does the term DNR stand for? A. Do Not Remove B. Do Not Resuscitate C. Due diligence Non-feasance Reprimand D. None of these “Where Education Comes To Life” Practice Practice Practice “Where Education Comes To Life”  Practice Practice Practice O What does the term DPOA stand for? A. Durable Partner of Attorney B. Diseased Power of Abuse C. Durable Power of Attorney D. None of these “Where Education Comes To Life” Practice Practice Practice “Where Education Comes To Life”  Thinking caps on … O Which of the following are true of Elder Abuse? A. Stealing a patient's belongings B. Inflicting injury and pain C. Mishandling monetary funds D. Withholding care such as food, drink, or medication E. Sexual abuse F. Threatening and/or confining a patient G. Must be reported “Where Education Comes To Life” Thinking caps on … “Where Education Comes To Life”  Thinking caps on … Are there any reason why an advanced directive would not be honored? A.Advanced directive is not on file and cannot be produced at the time a decision needs to be made B.Moral or religious beliefs C.The patient has not paid their bill “Where Education Comes To Life” Thinking caps on … “Where Education Comes To Life”  Which of the following… O Which are considerations when dealing with the elderly population? A. MEMORY- can’t remember to take medications on time B. MEDICATIONS- errors in taking the drugs because of compliance or not following directions C. DEPRESSION- signs of depression being confused with dementia or delirum “Where Education Comes To Life” Which of the following… “Where Education Comes To Life”