Focus on Practice Sample Paper

Focus on Practice Sample Paper

According to Chan, Peart & Chin (2014), advance Care planning refers to a process in which discussions and shared plans for health in the future are made by patients. It is also referred to as an advance health directive or living will. Advance care planning includes an individual, his/her healthcare providers and family members. The entire process may lead to a patient writing an advance directive, an advance plan of care or alternatively assigning an enduring power of attorney. An advance directive is considered to be a legally binding document that an individual expresses his/her wishes for treatment in future/during the end of life. For the purpose of this assignment, the use of advance directives and enduring power of attorney in the clinical settings will be discussed. From a legal perspective, advance directives/enduring power of attorney informs clinical decision making at the end of life or when an individual becomes mentally incompetent to make decisions regarding care. Focus on Practice Sample Paper



There are crisis situations that present in the clinical setting which are similar to that of Mrs. Berry whereby, she is currently not competent to consent to treatment and is not sectioned under the Mental Health Act. Neither does Mrs. Berry have an enduring power of attorney nor an advance directive. Such situations present healthcare providers with numerous challenges when providing care, circumstances that can equally be prevented through advanced care planning.

New Zealand’s older adult population (65 years and older) has the highest growth rate. By the year 2051, it is estimated that 1.18 million people will be 65 years and older: a 165% rise since the year 1999 (Street et al., 2015). The majority of this population has however failed to plan for end of life care in advance, partly due to lack of knowledge/information and partly due to not knowing when and what to talk about (Bradley et al., 2014). This discussion is an issue since it easily leads to disagreements amongst patients, families and their loved ones when making decisions about health in the end of life, when to stop or continue using medical procedures that sustain life (Peicius, Blazeviciene & Kaminskas, 2017).

In New Zealand, patients have the right to use advance directives which should either be in oral or written form according to the Code of Health and Disability Services Consumers Rights (Luckett et al., 2015). In this context, consumers make written or oral choices about healthcare procedures which are only intended to be used when incompetent. Besides, one can nominate a person   through the Protection of Personal Property Rights Act of 1988 to be his/her enduring power of attorney with regards to personal care (Luckett et al., 2015).Therefore, when incompetent, the appointed person will make decisions on behalf of an individual.

According to New Zealand laws, in this case, the attending physician ought to continue with the administration of standard medical treatments that are intended to save Mrs. Berry’s life or to prevent the occurrence of serious harm to her health (Carter et al., 2016). However, any other decisions regarding Mrs. Berry’s treatment should preferably be made by the attending clinician/physician by considering her best interests, if she were competent enough to make them (Carter et al., 2016)


Advance directives ensure that an individual’s interests and wishes are respected during a crisis. However, a crisis plan and an enduring power of attorney are even more effective in safeguarding an individual’s interests and wishes. The attending clinician in Mrs. Berry’s case should preferably be the one to make decisions regarding her health at now. He / She should start by administering standard medical treatments that are intended to save her life or to prevent the occurrence of serious harm to her health. Other decisions should be made with the patient’s best interests if she was competent to make them. Focus on Practice Sample Paper


Bradley, S. L., Woodman, R. J., Tieman, J. J., & Phillips, P. A. (2014). Use of advance directives by South Australians: results from the Health Omnibus Survey Spring 2012. Medical Journal of Australia, 201(8), 467-469.

Chan, T. E., Peart, N. S., & Chin, J. (2014). Evolving legal responses to dependence on families in New Zealand and Singapore healthcare. Journal of medical ethics, 40(12), 861-865.

Carter, R. Z., Detering, K. M., Silvester, W., & Sutton, E. (2016). Advance care planning in Australia: what does the law say?. Australian Health Review, 40(4), 405-414.

Luckett, T., Bhattarai, P., Phillips, J., Agar, M., Currow, D., Krastev, Y., & Davidson, P. M. (2015). Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria. Australian Health Review, 39(5), 552-560.

Peicius, E., Blazeviciene, A., & Kaminskas, R. (2017). Are advance directives helpful for good end of life decision making: a cross sectional survey of health professionals. BMC medical ethics, 18(1), 40.

Street, M., Ottmann, G., Johnstone, M. J., Considine, J., & Livingston, P. M. (2015). Advance care planning for older people in A ustralia presenting to the emergency department from the community or residential aged care facilities. Health & social care in the community, 23(5), 513-522.

Case_study_Mrs_Berry (1)

Focus on Practice Sample Paper


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