HLSU233 Nursing

Question 

Research and explain the legal and ethical considerations (national, State/Territory, local) relevant to the nursing profession, and how these are applied in nursing practice:

• living wills and advanced directives
• guardianship

Answer:

Living wills and advance directives

An advance directive sometimes referred as living will is written by the person themselves. It is a written record of that particular individual’s preference for future care like preferred outcomes, directions about care and treatments. Advance Care Directives can also formally appoint a substitute decision maker. The Advance Care Directives (ADC) in Australia differs between states and territories (Advance Care planning Australia 2018). In the Australian Capital Territory (ACT) the ADC is guided by three different options like enduring power of attorney,  complete and advance care plan statement of choices and complete health direction (recording future health care decision: withdrawal of treatment or choice of doctor) (ACT Government 2018). In New South Wales, the ADC is only applicable for the adults with decision-making capacity and no can over-ride the ACD not even the legal guardian appointed by the owner of the ACD (NSW Ministry of Health 2017). In NSW however, the potter of attorney can only take decision for the business and financial matter and not for health. However, ACD in Queensland states that power of attorney can take decision about health-related and personal matters (Queensland Government 2018). The ACD of Victoria provides an avenue to recruit a medical treatment decision maker in order to take decision on their behalf when they no longer have their own decision-making capacity (Victoria State Government 2016).  

Guardianship

En Enduring Power of Guardianship (EPG) is a legal document, which helps a person to appoint one or more than one person whom he or she trust or knows well as an ensuring guardian to make decisions on their behalf in the domain of the personal life, lifestyle factors and medical treatment decision. The concept of EPG is only applicable when they that very person in unable to take their own decision or is unable to communicate their decisions to others. This concept of helpful as it is not always possible for an ADC and a living will to anticipate ascertaining every future scenario that might happen to that person (Government of Western Australia 2018).

Nursing professionals are the one who spent most of the time with the patients during their stay in the hospital for long term-term care. Patients mainly want to discuss about the end-of-life care however prefers the healthcare professionals to initiate the discussion about this. It is important for the nursing professionals to initiate the discussion on the grounds of trust and openness that often characterized as the primary pillars of therapeutic relationships with the patients. Communication about the end of life care should be kept confidential and private. It should be done in such a manner that it strictly respects the autonomy of the patients. In order to apply this principle, the nurses must be prepared to advocate for a patient whose wishes are not respected. It is the ethical duty of the nursing professional to respect the decision of the patients made via ADC and to work according. However, none of the Australian States and Territories supports the concept of euthanasia or assisted dying thus decision of ending the life will not be taken into consideration by the nursing professionals (Kuniavsky, Kadmon and Chinitz 2015).  

References

ACT Government. 2018. Advance Care Planning. Access date: 15^th September 2018. Retrieved from: https://health.act.gov.au/public-information/consumers/advance-care-planning

Advance Care planning Australia. 2018. Advance Care Planning in your state and territory. Access date: 15^th September 2018. Retrieved from:  https://www.advancecareplanning.org.au/resources/advance-care-planning-for-your-state-territory

Government of Western Australia. 2018. Enduring Power of Guardianship. Access date: 15^th September 2018. Retrieved from:  https://healthywa.wa.gov.au/Articles/A_E/Enduring-Power-of-Guardianship

Kuniavsky, M., Kadmon, I. and Chinitz, D., 2015. Being a legal guardian–the nursing perspective. Israel journal of health policy research, 4(1), p.59.

NSW Ministry of Health. 2017. Making An Advance Care Directive. Access date: 15^th September 2018. Retrieved from:   https://www.health.nsw.gov.au/patients/acp/Publications/acd-form-info-book.pdf

Queensland Government. 2018. Advance Health Directive. Access date: 15^th September 2018. Retrieved from: https://www.qld.gov.au/law/legal-mediation-and-justice-of-the-peace/power-of-attorney-and-making-decisions-for-others/advance-health-directive

Victoria State Government. 2016. Advance care planning forms. Access date: 15^th September 2018. Retrieved from: https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/end-of-life-care/advance-care-planning/acp-forms