Death with Dignity: Medical Aid-in-Dying and Death with Dignity Laws

Course Code: REL-PAC-0-DDMADDL-R1

Hours: 2

Type: Online Course

Content Expiration Date: 2/28/2024

Learning Objectives:
Define medical aid in dying.
List states that have medical-aid-in-dying laws.
Identify other end-of-life options in addition to medical aid in dying.
List reasons a person may choose medical aid in dying.
Describe history behind passage of California’s End of Life Option Act.
Recognize eligibility requirements for medical aid in dying in states where it is legal.
Define process a person must follow to obtain prescriptions for medical-aid-in-dying medications.
Identify potential policies and processes a care community must consider in states with medical-aid-in-dying laws.

Outline:
I.Introduction to medical-aid-in-dying

a.Course description and objectives

b.A real account of medical-aid-in-dying

i.Brittany Maynard story

ii.Brittany Maynard video

c.Why medical aid in dying is important to healthcare professionals

d.Medical aid in dying and end-of-life care:relevant concepts and terms

i.Advance care planning(ACP)

ii.Advance directives

iii.Capacity to make medical decisions

iv.Death with dignity

v.DNR

vi.Euthanasia

vii.Hospice

viii.Medical-aid-in-dying medications

ix.Palliative care

x.Palliative sedation

xi.Physician-assisted suicide

xii.Refusal or withdrawal of medical treatment

xiii.State portable orders

xiv.Terminal illness

xv.Voluntary stoppage of eating and drinking(VSED)

e.Checkpoint 1

II.Medical aid in dying

a.Twentieth-century developments

i.Right to die:euthanasia

ii.Right to control decisions about medical care:advance directives

iii.DNR and the right to refuse CPR

iv.Access to specialized care:Hospice care and Medicare benefits

v.State portable orders

vi.Medical-aid-in-dying legislation and changing attitudes

vii.Technology and medical ethics

b.Case scenario:Jeff's story

c.Choices and support for the dying:palliative care

i.Pain and symptom management

ii.Hospice

iii.Voluntary stoppage of eating and drinking

iv.Withdrawal or refusal of healthcare treatment

v.Palliative sedation

d.Checkpoint 2

III.Medical aid in dying:legislation

a.State legislative processes

i.History of first state to enact legislation:Oregon

ii.Why people choose to use law

iii.States where medical aid in dying is legal:California, Colorado, Montana, Oregon, Vermont, Washington

iv.Insurance and medical aid in dying

v.Resources for understanding medical aid in dying in states where it is legal

vi.Summary of process(per legislation)

1.How to locate physicians willing to help

2.Oral requests

3.Physician responsibilities

a.Attending physician

b.Consulting physician

4.Psychological fitness

5.Waiting periods

6.Written request

7.How to obtain prescribed medications

vii.Checkpoint 3

b.California’s medical-aid-in-dying legislation

i.History and legislative efforts

ii.California End of Life Option Act

1.Passage in 2015;implementation on June 9, 2016

2.Statistics for first six months

iii.California process

1.Procedure for request

2.Physician's responsibilities

a.Prescribing process

i.Determination and discussion

ii.Specific counsel

iii.Provisions:withdrawal request, attestation form

3.Person’s responsibilities

a.Completion of attestation form(48 hours prior to planned death)

b.Self-ingestion while still capable

4.After death

iv.Checkpoint 4

IV.Important safeguards and considerations

a.Safeguards

b.Ethical considerations

i.Ethical issues in medical aid in dying

1.Introduction to ethics

a.Ethical principles

b.Religious ethics

2.Ethical principles

a.Respect for autonomy

b.Justice

c.Compassion

ii.Ethical issues in practice

1.Responsibilities of healthcare providers

2.Rights of persons in their care

c.How medical aid in dying applies to assisted living and residential care communities

i.Gladys’ story

ii.Explanation of salient issues

1.Choices and rights

2.

3.Determination of extent of participation

4.Development of policies and procedures

5.Communication and staff training

d.Workflow and coordination of care

i.Coordination of care

1.Hospice and other organizations

ii.Confidentiality and privacy

iii.Staff support

iv.Storage of medication

v.“Imminent threat process when not under hospice care

e.Checkpoint 5

V.Medical-aid-in-dying resources

a.National organizations

i.Compassion and Choices

ii.Death with Dignity National Center

b.State organizations

i.End of Life Choices Oregon, End of Life Washington, Patient Choices Vermont, Coalition for Compassionate Care of California

VI.Course summary

a.Conclusion

VII.Posttest

Instructor: Cynthia McDaniel, MSN, RN

Cynthia McDaniel MSN RN, is a nurse and administrative consultant in long term care. She is the CEO of ElderWise Inc, a senior living consulting and education group. Cynthia has worked as a nurse consultant for the States of Oregon and Washington,  a geriatric care manager, a regional director of clinical operations for a senior living company, and an assistant professor at Oregon Health & Science University School of Nursing. Her research in assisted living focused on the characteristics of residents in assisted living communities and the role of the nurse in assisted living. Cynthia holds a Master's of Science in Nursing from Gonzaga University in nursing education. She is a Fellow of the Sigma Theta Tau/John A. Hartford Foundation Geriatric Nursing Leadership Academy.  Disclosure: Cynthia McDaniel, MSN, RN has no Relevant Financial or Non-Financial Relationship with ineligible companies to disclose.

Target Audience:
The target audience for this course is: Administrators; in the following settings: Post-Acute Care.

Relias Learning will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.

Relias Learning has a grievance policy in place to facilitate reports of dissatisfaction. Relias Learning will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias Learning at support@reliaslearning.com.

Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.