SWGS 6471 Self-Reflection: Health Care Proxy

A healthcare proxy is an individual tasked with protecting the wishes and healthcare needs of a patient in the event of their incapacitation. Engaging a proxy is particularly common in situations where patients are likely to undergo treatment options that may limit their ability to communicate their needs (Berkman et al., 2018). Although most people understand the essential role a proxy plays in a patient’s life, the assumptions are theoretical in most cases. Therefore, I undertook a task to improve my understanding of the complexities and challenges of assigning a proxy for patients. Filling out a proxy form enlightened me on the psychological, emotional, and practical challenges patients face in their quest for an appropriate proxy.

One of the feelings I experienced when filling out the Heath Care Proxy Form was uncertainty. My uncertainty arose from my understanding of differences in interpretations when evaluating situations. Even though I was certain that the individual I chose would protect my best interests, I wondered if they would make the same decisions I would in various circumstances. Healthcare professionals understand the concept of self-determination and undergo training on various ways to protect the right of a patient (Nadicksbernd et al., 2011; Cameron & Keenan, 2010). However, most proxies lack access to the same opportunities, thus making it challenging for them to deal with ethical dilemmas objectively. Understanding the fear made me realize the necessity for an extensive conversation with my proxy on varying moral perspectives and specific elements to consider when establishing the best decision on my behalf. Secondly, I felt relief when filling out the form. The feeling arose from realizing I would have a person who understands my wishes and makes decisions on my behalf when I cannot. As much as healthcare practitioners have to adhere to the Hippocratic Oath, they also serve the business interests of their employers. Therefore, having a proxy participating in decision-making processes for care options on my behalf enhanced my confidence in receiving quality care without compromising my financial well-being. I chose an individual with access to my financial records and medical history as my proxy as they would understand my position on various decisions holistically. The individual would be able to gauge available resources, health, and beliefs when selecting the most appropriate options for me.

The experience of filling out the form will influence my experience with seriously ill persons in several ways. Firstly, I am more aware of the need for patience when dealing with such patients. The process makes it necessary for patients to evaluate their ailments and individuals within their support systems capable of catering to their interests holistically. The experience made me aware of the pressure arising from individual evaluations of loved ones for proxy identification purposes. My enhanced awareness of the emotional impact the proxy decision may have on family members, caregivers, friends, spouses, and other individuals offering support has increased my patience toward patients. Secondly, the experience has illuminated the need for patient education regarding proxies. In most cases, healthcare professionals and social workers leave the selection process to patients and offer little support in decision-making (Berlinger et al., 2013). It is necessary to advise patients on elements they may want to consider when choosing an appropriate proxy, including compatibility of core moral principles, availability during treatment, an understanding of the patient’s financial position, and the ability to maintain the right to self-determination through respecting wishes. The experience also made it possible for me to understand the need to provide proxy education on expected challenges at a patient’s request. Creating an avenue through which proxies and patients can meet to discuss their role in patient care and treatment is likely to ease anxiety around incapacitation.

During the experience, I found filling out the nutrition and hydration section necessary. Even though providing the information may seem redundant to most individuals, filling out the section makes it unnecessary for the proxy to establish an independent decision on the same. Further, moral or ethical arguments surrounding the issue make it necessary to reduce instances of clashing perspectives between healthcare professionals and the proxy (Bomba & Karmel, 2015). For instance, in a situation where intravenous nutrition and hydration are necessary, the proxy may experience discomfort regarding the procedure or location of the injection, thus increasing time spent on decision-making. Filling out the section would ensure that the proxy and the professionals understand my expressed wishes and implement them for the best possible care. The section ensures that the proxy does not make decisions deterring hydration and nutrition.

I chose a close family member as a healthcare agent. One of the reasons I made a choice is because of my personal social history with the individual. Close social interactions have made it possible for me to share personal information with the person, making it easier for them to make objective decisions. For instance, the person’s awareness of my aspirations would make it possible for them to consider the impact of treatment options on the aspirations. The individual would then be able to weigh the benefits of various treatment options against possible risks to my aspirations before making the decision. The considerations would protect my ability to receive quality treatment without compromising my quality of life after recovery. Secondly, the individual understands my sources of income, the financial capacity to cover various bills, and contacts likely to offer assistance where necessary. Lastly, the individual shares the same moral perspectives on self-determination and the right to treatment and understands some of the challenges I will likely face when receiving care based on cultural elements. I am confident in the individual’s ability to execute the role without overlooking my interests. I know that the person may experience some challenges when making hard medical decisions, but I am confident in their ability to protect my interests. The role imposes an obligation on the agent, which most people in my family would not manage, thus voiding the chances of a feud regarding my choice.

I engaged the person I chose about my wishes. However, the engagement was brief and only covered the essence of the role. I will need to have a candid conversation with the person to ensure they understand the expectations of the role’s acceptance for both of us. It will be necessary to discuss elements in the form, individual abilities, challenges likely to arise, and support available where necessary. The discussion will also allow me to listen to the agent and understand some of their perspectives and concerns. The latter is necessary for easier role adoption when the time arises. The candid discussion will serve as a platform for us to prepare for the eventualities requiring the role’s implementation. Despite the bleak nature of the conversation, it will make it possible for the agent to navigate the process and ease my mind concerning my fate.

References

Berkman, C., Stein, G. L., & Glajchen, M. (2018). Palliative and end-of-life care. In J. C. Heyman & E. Congress (Eds.), Health care and social work: practice, policy and research: Springer.

Berlinger, N., Jennings, B., & Wolf, S. M. (2013). The Hastings Center Guidelines for Decisions on Life-Sustaining Treatment and Care Near End-of-Life (2nd ed.): Oxford University Press.

Bomba, P. A., & Karmel, J. (2015). Medical, ethical, and legal obligations to honor individual preferences near the end of life. NYSBA Health Law Journal, 20(2), 28-33.

Cameron, M., & Keenan, E. K. (2010). The common factors model: Implications for transtheoretical clinical social work practice. Social Work, 55(1), 63-73.

Nadicksbernd, J. J.,Thornberry, K., & Charles F. von Gunten, C. F. (2011). Social work and physician collaboration in palliative care. In Altilio, T., & Otis-Green, S. (Eds). Palliative Social Work by Oxford UP