CHAPTER 9

Lakian, Sinamban

REPORTERS: Almuqati,

Withholding and Withdrawing Life Support

Goal: To understand the various arguments used and the types of patients involved in the issues of withdrawing and withholding life support. Key Terms:

Advanced Directives- Documents that relate to others your wishes should you lose the ability to relate these matters yourself. Best- interest standard- a proxy decision making standard where the guardian is directed to make the decision in the best interest of the individual. Biographical Life- Life in the sense of events and the ability to have relationships. Biological life- life that separates the living from the nonliving. Clear and Convincing evidence standard Cognitive sapient state- a condition in which the individual has the ability to reason Do-not-Resuscitate order (DNR) - those orders when a determination is made that the level of life that could be sustained following a resuscitative effort would be such that it would not be in the patients best interest to perform resuscitation. Durable power of attorney- a legal document that identifies another individual who is empowered to make decisions for you in your absence or inability to make your wishes known. Euthanasia- an easy death; act of killing or permitting death without suffering. Ordinary and Extraordinary care- a differentiation used to determine what level of care is required and the level that might be considered optional due to high cost, low effectiveness or other criteria. Patient Self-determination Act of 1990 (PSDA)- mandates that all health care providers receiving federal reimbursements for services provide information to each patient and offer the option of initiating an advanced directives. Persistent vegetative state- a state characterized by a permanent eye-open level of unconsciousness. Personhood- the individual state in which one is accepted as having the criterion of humanity. Quality of Life issue- the question of whether the potential quality of an individuals life is the primary consideration regarding decisions involving resuscitation or extraordinary measures.

Right to die Movement- a group of individuals who subscribe to the concept that along with the protected rights to life, liberty and the pursuit of happiness, individuals have the right to decide when life should be ended. Substituted-judgment standard- a proxy decision making standard whereby guardian is directed to make the decision compatible with the previous wishes of the individual.