March 10, 2014 | Posted By Jane Jankowski, LMSW, MS

As a clinical ethicist, many of the requests for assistance that come my way have to do with advance directives, either the lack of any documented wishes, incomplete or unfamiliar forms, or otherwise confusing messages about what a patient truly wants when it comes to life sustaining medical treatment. Too often, my help is needed when the patient is no longer able to tell others what he or she wants and does not want. On one such call, a group of compassionate nurses and I sifted through a charts to see what we could learn about a particular patient’s known wishes. In the course of our conversation, a nurse asked me if I had heard about LaCrosse, Wisconsin where 98% of the town’s population has advance directives. After giving me a quick summary between her own patient charting, delivering meds, and coordinating a pending admission, she printed the article. For anyone who missed it (like me) the link is here: LaCrosse Wisconsin on NPR.

The success of the campaign to get folks in this one town to think and talk about the end of life more comfortably as well as plan ahead for medical care owes its success to a grassroots effort. Similar undertakings have occurred elsewhere, but have been more piecemeal. Death Cafes, MOLST, POLST and other endeavors to help people consider end of life issues are examples, but bringing these things together is the bridge that must occur nationwide in order to remedy the problem of doing what the patient wants when they are too sick to tell providers what they want. The silver lining is that costs can be saved, but heartache and strain on loved ones is perhaps the biggest savings of all.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

1 comments | Topics: Advance Directives , DNR , End of Life Care



Jeremy wrote on 05/05/14 5:29 PM

well I think this is the great example set by this person, especially when we talk about advance directives. SO, thumbs up for that man.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.