Earn and download a certificate immediately upon completion of this module.
Course 2D - The Ethics of Advance Directives: Assisting Clients and Families with Plans for End of Life Care
This course is sponsored by CEU by Net and is approved and/or pre-approved or automatically approved for 2 credit hours by multiple State Boards including Texas, Alabama, and Florida, TCBAP-TAAP, IC&RC, NAADAC, and Florida Certification Board. EACC awards 2 Total PDHs in Domains I, III effective April 10, 2018. Course also awards 1.25 CA BBS Hours as of 10.01.15 and 2.0 before, and 1.25 NBCC Hours as of 05.01.15 and 2.0 before.
This sponsored course is both an ETHICS course and a COUNSELING INTERVENTION course for working with cancer patients, AIDS patients, stroke patients, terminally ill children, and others who are coping with End of Life Issues. Say the authors, "Predicting what treatments patients will want at the end of
life is complicated by the patient’s age, the nature of the illness, the ability of medicine to sustain life, and the emotions families endure when their loved ones are sick and possibly dying."
As with all of our courses, you can read the course material and print the quiz for FREE before you decide to enroll in the course. 90% of our course material may also be printed in advance, before or after you make a decision to enroll. Study off-line if you like, and take the quiz online to obtain your INSTANTLY DOWNLOADED CERTIFICATE.
The course document is published in the public domain and is accessed free of charge. It is a RESEARCH-BASED publication of the federal Agency for Healthcare Research and Quality (AHRQ), written by Barbara L. Kass-Bartelmes, M.P.H., C.H.E.S., and Ronda Hughes, Ph.D..
Why can this course be counted EITHER as a treatment intervention course or an ethics course? Because the issue of counseling dying or gravely ill or at-risk people and their families regarding their decisions for End of Life Care (Advance Directives) is fraught with both ETHICAL and INTERVENTION issues. The counselor is assisting individuals and families in making a decision about the care they will receive (or not receive) in the final stages of terminal illness or injury. Choices they need to make include DNR (Do Not Resuscitate) or 'IV hydration but no IV nourishment', or 'maintain fluids and nourishment indefinitely' or 'no mechanical respiration' vs. 'all life support measures possible', and the like.
Such counseling assistance is a delicate matter, and can be difficult for counselors to carry out without inadvertently inserting their own biases into the intervention. This is an ethics issue which also affects the counseling approach. This course teaches a specific research-based method to avoid such conflicts.
The main issue in working with people who are seriously ill is, how far do you want medical personnel to go, to delay death? AIDS patients differed significantly from other ill patients, in several areas. There are also circumstances in which the reaction of the patient to discussing such issues varies significantly, depending upon the specific illness and age of the individual - including the reaction of terminally ill children.
The research therefore calls upon Behavioral Health and other medical professionals to tailor the approach according to the illness and the situation, i.e., HIV-AIDS vs Cancer vs Stroke vs. Alzheimer's .... and impending death vs. uncertainty of when death will occur.
The course document provides a ‘FIVE-STEP APPROACH to helping clients and families or partners to reach a decision about End of Life treatment preferences. The approach is a 'KNOWLEDGE FRAMEWORK’ and a 'GUIDELINE' for working with individuals with differing medical issues and life circumstances including AIDS -- and to do it ethically.
Specifically, the research included discussion with patients of various conditions which they could face when he or she nears the end of life, including severe pain, severe stroke, permanent coma, etc.. The patients were then asked to indicate which of these circumstances they would consider worse than death, i.e., under which conditions they would NOT want measures to be taken to prolong life. AIDS patients differed significantly from other ill patients in not wanting to prolong life under these circumstances.
Clients/Patients may be residents of nursing facilities, hospitals, hospice, or any other location where end of life is an issue - including those still living at home who have chronic diseases such as cancer, kidney failure, CHF, and HIV/AIDS -- where there is considerable uncertainty about when death is likely to occur.
This course is also helpful for those providers who work with HEALTHY individuals who work in life-threatening situations including MILITARY deployment to war zones, police officers, firemen, SWAT teams, undercover agents and other such at-risk occupations.
The AHRQ is an agency of the US Department of Health and Human Services. This free internet-accessible publication is authored by Barbara L. Kass-Bartelmes, M.P.H., C.H.E.S., and Ronda Hughes, Ph.D.
To READ and PRINT the online article and the quiz for free, just click the + sign below this summary.
GOALS OF THIS COURSE:
1. Learn the terms pertaining to individuals' and surrogates' LEGAL RIGHT to make 'End of Life' care decisions.
2. Develop an awareness of the research-verified need for clearer documentation and communication of patients' and surrogates' preferences for End of Life Care within the clinical record and in the direct communication provided to the treating physician and other caretakers.
3. Understand the THERAPEUTIC BENEFITS and the ETHICS of engaging in discussions about ‘end of life preferences‘ with applicable clients and their partners, spouses, families or surrogates (representatives).
4. Know that decisions about Advance Directives are important at multiple stages of proximity to death -- whether planning for an imminent end of life (as with late-stage AIDS patients and other critically ill people), or adjusting to a diagnosis of serious or critical illness, or coming to terms with the risk of critical injury in high-risk employment (military, law enforcement, etc.).
5. Learn that the choices for End of Life Care vary significantly, depending upon the specific type of life-threatening illness and related factors -- including the choices most often made by AIDS patients which limit or rule out medical interventions to prolong life vs. the choices made by other patients with a different illness.
6. Learn a five-part, research-supported PROCESS for structuring discussions about End of Life preferences, which inherently supports our ETHICAL RESPONSIBILITY for assuring the welfare and legal rights of the client.
This publication is dated 2003. However, the AHRQ considers this document to be nevertheless highly relevant to the subject at hand, when compared to other documents available within their research library and available elsewhere on the internet. This article is listed 3rd on the list of 261 AHRQ publications on this topic when most recently reviewed.
Note: You are free to read, download, save, and print the Study Guide(s) and Quiz(zes) for this Course, before deciding to enroll in the course. These course materials are public domain, and CEU By Net is sponsoring the course for CE Credit. You may STUDY THIS COURSE and the quiz AT NO CHARGE. You may enroll in the course at any time. You must take the quiz ONLINE, by logging into your
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