ABSTRACT
This report examines whether long-term care facilities should implement policies and procedures to support advance care planning by proxy for residents who lack decision-making capacity. The report focuses on advance care planning in the Department of Veterans Affairs. After reviewing clinical, legal, and ethical perspectives, the authors conclude that advance proxy planning is ethically sound and can improve patient care. However, because experience with advance proxy planning is still fairly limited, the authors do not recommend that a particular standardized approach be mandated at the national level. Instead, local facilities are advised to develop their own policies and then evaluate their effect. The report contains specific recommendations for the advance proxy planning process.
Subject(s)
Advance Directives/legislation & jurisprudence , Hospitals, Veterans , Long-Term Care/legislation & jurisprudence , Mental Competency/legislation & jurisprudence , Proxy/legislation & jurisprudence , Decision Making , Ethics, Medical , Humans , United StatesSubject(s)
Bioethical Issues , Bioethics , Advance Directives , Altruism , Beneficence , Decision Making , Delivery of Health Care , Education, Medical , Ethicists , Ethics , Ethics Committees , Ethics Committees, Clinical , Ethics, Institutional , Freedom , Health Care Rationing , Health Facilities , History , Humans , Informed Consent , Jurisprudence , Medicine , Patients , Personal Autonomy , Physicians , Resource Allocation , Social Justice , Third-Party ConsentABSTRACT
This paper gives a brief historical review of herbal medicines in Jamaica-focusing on its practitioners through obeah, myalism and the balmyard system. It highlights the role of the Department of Social and Preventive Medicine, U.W.I. in exposing medical students to traditional medicine, and the philosophy of the Department as it supports this position. It submits aspects of research projects carried out by medical students on the subjects in years 11, 111 and 1V of community medicine clerkships, and concludes with relevant supportive comments by the co-ordinator of the year IV clerkship. (Summary)
