Dying Tax Free: The Modern Advance Directive and Patients' Financial Values
Kirk, Timothy W
Luck, George R
Journal of pain and symptom management 2010 Mar ; 39(3): 605-9
Advance directives are often used to help patients articulate their end-of-life treatment preferences and guide proxy decision makers in making health care decisions when patients cannot. This case study and commentary puts forth a situation in which a palliative care consultation team encountered a patient with an advance directive that instructed her proxy decision maker to consider estate tax implications when making end-of-life decisions. Following presentation of the case, the authors focus on two ethical issues: 1) the appropriateness of considering patients' financial goals and values in medical decision making and 2) whether certain kinds of patient values should be considered more or less relevant than others as reasons for expressed treatment preferences. Clinicians are encouraged to accept a wide range of patient values as relevant to the clinical decision-making process and to balance the influence of those values with more traditional notions of clinical harm and benefit.
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National Hospice and Palliative Care Organization (NHPCO) Position Statement and Commentary on the Use of Palliative Sedation in Imminently Dying Terminally Ill Patients Kirk, Timothy W; Mahon, Margaret M; , (2010-05)
Effectiveness of Computer-Generated Reminders for Increasing Discussions About Advance Directives and Completion of Advance Directive Forms: A Randomized, Controlled Trial Dexter, Paul R.; Wolinsky, Fredric D.; Gramelspacher, Gregory P.; Zhou, Xiao-Hua; Eckert, George J.; Waisburd, Marina; Tierney, William M. (1998-01-15)BACKGROUND: Physicians can increase the rate of completion of advance directive forms by discussing directives with their patients, but the means by which physicians can be induced to initiate these discussions are unclear. ...