Patient autonomy is a basic tenet of ethical decision making in medicine. Individuals who are unable to participate in decision making at the end of life present a unique challenge to delivering ethical patient-centered care. To ensure patient autonomy is upheld, providers are encouraged to use healthcare directives to guide clinical decision-making. Healthcare directives are designed to uphold patient autonomy by indicating the desired scope of care at the end of life. While a particular type of healthcare directive, the advance care directive, is widely accepted, there are two common issues concerning its use: interpretation and accessibility. Issues with advance care directives have been largely circumvented by a new method of documentation: the physician order for life sustaining treatment (POLST). In addition to a review of the ethical issues pertaining to healthcare directives, this paper will outline a multi-methodological study proposal developed with support from the Lindmark Fellowship in Ethics.
Pathoulas, James T., "Ethical Documentation at the End of Life" (2015). Lindmark Fellowship in Ethics. 1.