________________________

Advance Directives

and Surrogate

Decision Making

in Illinois

________________________

Edited by

Thomas May

and

Paul Tudico

 

Sponsored by

Clinical Ethics Center

Memorial Medical Center

and

Department of Medical Humanities

Southern Illinois University School of Medicine

For ordering information click here

Summary
Decision-making for decisionally incapacitated patients is one of the most complex and confusing areas of contemporary health care, and problems arise in this area on an almost daily basis. Adding to the complexity of this area is the fact that decision-making procedures for decisionally incapacitated patients are State-specific, thereby making it difficult to generalize from other regions. The State of Illinois has a number of recognized decision procedures and mechanisms for incapacitated patients, including the Living Will, Durable Power of Attorney for Health Care, Mental Health Treatment Declaration, Illinois Health Care Surrogate Act, and the State of Illinois Guardianship and Advocacy Commission. Each of these has its own set of rules, guidelines, conditions of application and limitations.

After conducting a series of in-services and lectures for Memorial Medical Center and other community organizations, we recognized substantial confusion concerning these mechanisms and procedures among healthcare professionals. On the basis of this, we organized a continuing education conference on the topic of "Advance Directives and Surrogate Decision Making in Illinois: What they are and how they work in clinical practice," which was held in May, 1997. The response to this conference was astounding, and we filled the capacity for the conference center quickly. As a result, we have collected the lectures delivered at that conference, and asked authors to re-work each presentation for publication here.

All papers have been revised to reflect the most recent developments surrounding advance directives and surrogate decision making in the state. The chapters in this volume include two papers not presented at the conference, including a chapter on ethical issues in surrogate decision making, and a chapter on decision making for children. We believe this collection should be useful as a resource guide for ethics committees, nurses, physicians, residents, and medical students throughout the state of Illinois.

Table of Contents
List of Contributors ............................................................................................................... 4

Preface .............................................................................................................................. 51

Legal Aspects of Advance Directives and Surrogate Decision-Making in Illinois ........................... 7
Theodore R. LeBlang, J.D.

2. Standards for Ethical Decision Making at the End of Life .....................................................21
Mark P. Aulisio, Ph.D.

3. Advance Directives: Theory and Practice .......................................................................... 35
Thomas May, Ph.D.

4. The Illinois Health Care Surrogate Act ............................................................................. 49
J. M. Craig, M.A., Ph.D. (c) and Andrew Varney, M.D.

5. Adult Guardianship in Illinois .......................................................................................... 65
Aletha Turner, M.S.W. and the Illinois Guardianship and Advocacy Commission

6. Legal Parameters of Medical Ethics Decision Making for Minors in Illinois ......................... 79
Bethany Spielman, Ph.D., J.D. and Kimberly Doody, B.S.

7. The Illinois Mental Health Treatment Preference Declaration ............................................. 89
John Tomkowiak, M.D.

8. Counseling Families About End-of-Life Decisions ............................................................ 99
Gary W. Sproat, M.Div., B.C.C.

Index ............................................................................................................................. 121

List of Contributors
Mark P. Aulisio, Ph.D., Research Assistant Professor, Department of Internal Medicine, Assistant Director, Consortium Ethics Program Faculty, Center for Health Law and Ethics, Fellow, Center for Philosophy of Science, University of Pittsburgh.

Jana Craig, M.A., Ph.D.(c), Clinical Ethicist, Clinical Ethics Center, Adjunct Assistant Professor, Department of Medical Humanities, Memorial Medical Center and Southern Illinois University, School of Medicine, Springfield, IL.

Kimberly Doody B.S., 4th year MD/JD student at Southern Illinois University.

Theodore R. LeBlang, J.D., Professor and Chair, department of Medical Humanities, Southern Illinois University, School of Medicine, Springfield, IL.

Thomas May, Ph.D., Director, Clinical Ethics Center, Adjunct Associate Professor, Department of Medical Humanities, Memorial Medical Center and Southern Illinois University, School of Medicine, Springfield, IL.

Bethany Spielman, Ph.D., J.D., M.H.A., Assistant Professor of Medical Humanities, Southern Illinois University, School of Medicine, Springfield, IL.

Gary Sproat, M.Div., Director, Pastoral Care, Memorial Medical Center, Springfield, IL.

John Tomkowiak, M.D., Assistant Professor of Psychiatry, Southern Illinois University, School of Medicine, Springfield, IL.

Paul Tudico, M.A., Ph.D. (c), Instructor, Department of Philosophy, East Tennessee State University.

Aletha Turner, M.S.W., Regional Administrator, East Central Office, Illinois Guardianship and Advocacy Commission.

Andrew Varney, M.D., Assistant Professor of Medicine and Medical Humanities, and Director, Internal Medicine Residency Program, Southern Illinois University, School of Medicine, Springfield, IL.