Planning for Uncertainty by David John Doukas & William Reichel

Author:David John Doukas & William Reichel
Language: eng
Format: epub
Publisher: Johns Hopkins University Press
Published: 2007-01-23T16:00:00+00:00

6

THE VALUES HISTORY: DEFINING YOUR HEALTH CARE VALUES

Suppose you are thinking about having a living will and/or a durable power of attorney, but they don’t seem sufficient to record what you wish to say on this subject. Is there any additional way for you to provide your loved ones and your doctor with more detailed information about and understanding of your wishes regarding specific approaches to care and treatment?

What is the Values History?

The “Values History,” an advance directive form developed by Dr. David Doukas and Dr. Laurence McCullough, is designed to enhance current advance directives. (Dr. Edmund Pellegrino coined the term value history in the early 1980s to describe the discussions that might take place that would enable a doctor to elicit the values that are important to a patient’s health care decisions, and the naming of the Values History instrument has been an enduring tribute to Dr. Pellegrino’s pioneering efforts.) The Values History by Doukas and McCullough (see Appendix of this book) is intended to supplement a living will or durable power of attorney by stimulating a person’s thinking about specific medical values and eliciting from people statements concerning the values that would be important to them in the event of a terminal illness or if they were in a persistent vegetative state. Further, the Values History contains explicit advance directive statements regarding many medical therapies. An individual can complete these statements and be assured that the document will clearly state his or her wishes to family members and health care personnel.

This document allows the person to specify for each treatment the person’s acceptance, rejection, or—a third choice—the person’s willingness to have the health care team attempt a trial of that intervention. In a trial of intervention, a therapy is carried out for a specified period or as long as it takes to determine either that a specific benefit will be gained through the therapy or that the treatment is without benefit.

The Values History is a valuable tool to help you in the advance directive process. We believe that using the Values History by Doukas and McCullough has the following advantage: by prompting you to reflect meaningfully on your medical values and by preparing you to formulate specific advance directives, the Values History allows you to express your values more meaningfully and more specifically than other documents do. At the same time, the Values History facilitates your reflection on these important values through a series of questions and statements. These values and preferences are then discussed with your proxy and with those family members and loved ones whom you want to be part of your future medical decisions, so that your autonomy can be better respected through enhanced communication. This values conversation may be pivotal to your own end-of-life care.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.