Bioethics: Advance Care Directives

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Through the implementation and process of ACP there are several potential benefits and potential issues which may arise. During a study Singer et al. (1998) undertook they explored ACP from the clients’ perspective. This study helps establish the benefits of ACP in which the participants stated the purpose of ACP and the benefits from their own experience. The study concluded that ACP not only prepared the clients for incapacity but for death, they described their main goal of ACP as maintaining control when they are incompetent to make medical decisions (Singer et al., 1998). The participants noted ACP as a social process as it helped to relieve their death anxiety and it was not only an advanced directive form but it was the planning over …show more content…
The foremost legal issue is that there is currently no legislation in Ireland which requires healthcare workers to obey advance directives (Law Reform Commission, 2009). Although in the United States the patient self-determination act (PSDA) was passed by the United States congress in the year 1990, this enabled patients to make decisions regarding their treatment and supports their right to make their own medical decisions, It is estimated that 20% of patients in the United States have completed advance care directives (Urden, Stacy & Lough, 2012). In the year 2009 the Law Reform Commission published a report on Bioethics: Advance Care Directives. The main recommendations identified by the Law Reform Commission (2009), included that a legislative framework should be implemented, informed decision making should be a leading principle, an advance directive should be applied if the treatment is specified in it, all circumstances outlined are present and there is no evidence of the patient changing their mind and finally a code of practice should be drafted to provide guidance on the creation and execution of advance care directives. The ethical issues which emerged from the advance care planning process are based on the ethical principle patient autonomy. Patient autonomy is defined as the patient having the right to make their own medical decision without the influence of their healthcare provider (Schermer, 2010). The evidence suggests that there is a lack of autonomy presented in the decision making process during end of life care, the barriers which were identified in this study included continuity, collaboration and communication, all of these have an effect on how well the ACP process is delivered (Zalonis and Slota, 2014). Coleman (2003) also identified continuity, collaboration and communication as barriers to effective care delivery and presumptuously resulting in lack of autonomy
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