Advance Care Plan
Advance care planning is a thoughtful process to plan for future
healthcare choices, involving personal reflection and discussions
about medical treatment preferences.
Advanced Dementia
The patient is generally awake and able to respond but is confused
as far as time, place, and names with impaired memory, vocabulary,
and ability to reason because of deterioration of brain function
not due to medication or a transient or reversible condition.
Advance Directive / Living Will
A legal document by which the patient states his or her
preference to forgo life-sustaining treatment during terminal
illness or a terminal state of unconsciousness.
Allow Natural Death
Refers to decisions that can be made NOT to have any
treatment or procedure that will only delay the moment of death and
applies only where death is about to happen from natural causes
Antibiotics
Medications used to fight infections. Used to treat
illnesses or relieve symptoms.
Autonomy
The principle of autonomy gives to the adult competent individual
the right of self-determination and to have full control over
decisions related to invasion of the body.
Beneficence
The physician should be the patient's advocate under all
circumstances. The patient's well-being should be placed above the
physician's self-interest.
Breathing Machine / Ventilator / Respirator
Mechanical ventilation is used to support or replace the
function of the lungs. A breathing machine is attached to a tube
inserted through the nose or mouth and into the windpipe and forces
air into the lungs. Mechanical ventilation is often used to assist
a person through a short-term problem or for prolonged periods in
which irreversible respiratory failure exists.
Capacity
The ability to take in information, understand its
meaning and make an informed decision using the information.
Cardiopulmonary Resuscitation (CPR)
Attempts to restart breathing and the heartbeat of a
person who has no heartbeat or has stopped breathing. CPR involves
"mouth-to-mouth" breathing and forceful compressions on the chest
to restart the heart. Usually involves electric shot
(defibrillation) and a plastic tube down the throat into the
windpipe to assist breathing (intubation).
Coma
Total unawareness of self and environment with no periods
of awakening; could be deep with total lack of response or less
deep when some reflex response could be evoked with
stimulation.
Comfort measures / comfort care
Medical care provided with the primary goal of keeping a
person comfortable rather than prolonging life. Comfort measures
are used to relieve pain and other symptoms.
Competence To Make Medical Treatment
Decisions
Not necessarily equivalent to legal competence. It stipulates that
the patient is able to understand, evaluate, and choose a
treatment.
DNR
Do-not-resuscitate order: indicates that for medical
reasons or a terminal condition CPR is inappropriate in the event
of cessation of the heartbeat or breathing.
Feeding Tube
A small plastic tube, inserted through the nose, or
directly into the stomach or intestines to feed someone who can no
longer swallow food.
Healthcare Surrogate / Proxy
A proxy decision maker to make healthcare decisions when
the patient is no longer competent to make them.
Informed Consent
The patient agrees to a certain medical intervention based on his
or her evaluation of all relevant information about the procedure,
alternatives, and the competence of the treating team.
Intravenous (IV) fluids
A small plastic tube (catheter) is inserted directly into
the vein and fluids are given through the tube.
Life-sustaining Treatments
Refers to medical or surgical treatments such as tube
feeding, breathing machines, dialysis, some medications and CPR
that use artificial means to restore life and without which the
patient will die.
Nonmaleficence
"First do no harm" is the first law in the practice of
medicine.
Patient Self-Determination Act
(Part of Budget Reconciliation Act of 1990, PL 101-508,
sections 4206, 4751)
A federal law, implemented in December 1991, that requires
institutions to notify patients about the availability of formal
advance directives.
Permanent Vegetative
State
Irreversible vegetative state due to severe injury or acute oxygen
deprivation to progressive degenerative metabolic or developmental
brain disorder.
Persistent Vegetative State
A vegetative state that has persisted for a period of time (three
months when caused by disease and twelve months after head
injury).
POLST
Physician Orders for Life Sustaining Treatment was
started in Oregon in the early 1990's to improve the quality of
medical care provided by turning people's wishes regarding life
sustaining treatments into medical orders.
Shared Decision-Making
An adult, competent individual has the ultimate right to
accept or refuse medical treatment even if that decision is deemed
irrational or harmful.
Tube-feeding
Providing fluids and/or nutrition by way of a tube placed
into the stomach or intestines. On a short-term basis, the tube
(nasogastric tube or "NG-tube") is placed into the nose, down the
throat and into the stomach. For the long-term, the tube is placed
directly into the stomach (gastric, or "G-tube").
Vegetative State
Unawareness of self and environment with sleep-wake
cycles and with either complete or partial preservation of
brain-stem autonomic functions.