NJ Ethics Committess Mediate Crucial End-of-Life Decisions

When a nursing home resident can no longer make decisions, someone else has to make the tough ethical choices. Should the patient's life be prolonged with a ventilator or feeding tube? Has the time come to remove life support? What would this person have wanted? The family and the nursing home staff can wind up at loggerheads, unable to take the next step.

The state's ethics committees are helping families and nursing home staff make these tough decisions. The regional panels are made up of trained volunteer professionals with diverse backgrounds, including nursing, social work, long-term care, and clergy. They work under the direction of the state Office of the Ombudsman for the Institutionalized Elderly, which advocates for patients in long-term care facilities.

The ethics committees "are available to people to help them through an extremely difficult and hard time and help them critically think through issues and make decisions that are ultimately resident focused," said ombudsman James McCracken.

McCracken wants to raise the visibility of these ethics committees and encourage nursing homes to call on them to mediate more often. To do so, he is presenting this month training sessions, "How to Make Ethical Decisions at the Bedside," taught by clinical ethicist Dr. Helen D. Blank and designed for ethics committee members and nursing home staff.

A new law gives New Jersey residents the final say on their medical care. The planning document, called the "Physician Orders for Life Sustaining Treatment" or POLST, details the individual's wishes for the quality of life and medical intervention in their final days. The document has the authority of a medical order and follows the patient from one care setting to another, including home, ambulance, hospital, nursing home, and hospice.

POLST is designed to supplement the living will or advanced directive, which individuals typically use to designate a healthcare proxy who will make decisions when they are no longer competent to direct their own medical care. A committee of the New Jersey Hospital Association is expected to create a POLST form to be used throughout the state by the end of the year.

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NJ Ethics Committees Mediate Crucial End-Of-Life Decisions