Six Steps to “Now Care Planning”
“Now Care Planning” is for patients who want a peaceful, timely dying, but who:
(A) Have already reached the advanced stage of dementia;
(B) Depend on another’s hand to put food and fluid in their mouth; and,
(C) Have lost mental capacity so they cannot either complete a new living will or revise their existing living will that is not adequate and/or not effective.
Defining what makes living wills adequate and effective:
A living will is adequate if it clearly informs future physicians and others precisely “when” patients would want others to allow them to die of their underlying disease.
A living will is effective if (i) the intervention it offers (its “what”) can allow patients to have a private, peaceful, and timely dying, and if (ii) physicians and other authorities can view the intervention as acceptable.
Unfortunately, few living wills meet these criteria and the results can be sad. Loved ones may feel helpless for years as they watch patients endure prolonged dying with possible suffering.
These Six Steps expand the traditional protocol of Substituted Judgment, which is widely accepted as legal and ethical. The “Now Care Planning” Protocol strives to present robust data and convincing arguments to treating physicians. It also includes several layers of safeguards designed to prevent premature dying. A counseling healthcare provider is required to guide the legally designated currently active proxy/agent and two or more proxy/agent alternates and possibly concerned others through the Protocol. The intermediate goal is to make the same treatment decisions patients would have made—if patients had been asked when they still possessed decision—making capacity to judge if their present condition would cause “severe enough suffering.”
The ultimate goal is to convince a physician to write the orders for Natural Dying so the patient can avoid a prolonged dying with severe suffering by having a private, peaceful, and timely dying that is based on their values.
Step 1: Do concerned individuals who know the patient’s values, think the patient qualifies for “Now Care Planning”? Are these individuals legally and clinically qualified to serve as members of a new patient’s Decision Committee? Are they willing to give their informed consent to serve?
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Click to Continue to Read How Each of the Six Steps Works,
How it can Benefit Your Loved One, and Why it is Unique...