Definitions related to ACP
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To understand the process of advance care planning, it is important to become familiar with the associated terminology. Here are a few of the most important words to know.
01
Advance care planning is a "process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. The goal of advance care planning is to help ensure that people receive medical care that is consistent with their values, goals and preferences during serious and chronic illness" (Sudore, et al., 2017, p. 826).
02
Advance directives, living wills, are directions, usually in a written format, but not always, from a competent person specifying health care treatment preferences that should be followed if that person becomes unable to voice those preferences on their own.
03
Autonomy comes from Greek words meaning self rule and refers to the individual's right of self-determination over medical health care decisions. It is the right to make health care decision, based on one's own personal system of values and beliefs, even if the decision may lead to one's death.
04
Capacity (competence) is defined as a person's ability to make informed decisions regarding health care for themselves. Capacity is a clinical determination whereas competence is a legal determination.
05
Do not resuscitate (DNR) is a physician's order in a patient's medical record to not revive a patient in cardiopulmonary arrest. Patients may have a copy of a DNR order in their home should emergency personnel be called in. A DNR tattoo is not a legal document from a physician and should not be honored. A DNI order (do not intubate) is a similar order to not connect the patients to a breathing machine.
06
Euthanasia is the act of either allowing the patient to die due to an underlying disease process (Passive euthanasia) or intentionally ending a person's life (Active euthanasia). Active euthanasia may be voluntary (at the request of the patient), nonvoluntary (without a request from the patient), or involuntary (against the patient's request).
07
Informed consent is the legal and ethical requirement that no medical procedure can be performed until the competent patient, or a legal surrogate decision maker, has been informed of the nature of the procedure, risks involved, and possible alternatives, as well as the prognosis if the procedure is not done. The patient must freely and voluntarily agree to the procedure, and in many cases, this consent is in writing.
08
Power of Attorney (POA) is a legal document that identifies and empowers an agent, surrogate, proxy, or decision maker to make decisions on your behalf. POAs can be general, over all of your affairs, or specific such as a health care POA. POAs can be written to take effect immediately or only if you should become incapable of making your own decisions. Remember, you could become incapable of making decisions only on a temporary basis, due to an accident, or a permanent basis, from major illness or disease.