Are Young Adults Ready to Complete Advance Directives?

2022 ◽  
pp. 104990912110664
Author(s):  
Yuchi Young ◽  
Arianna Stone ◽  
Taylor Perre
Keyword(s):  
New York ◽  
Young Adults ◽  
Advance Directives ◽  
End Of Life Care ◽  
New York State ◽  
Medical Intervention ◽  
Medical Interventions ◽  
Life Sustaining Treatment ◽  
The Mean ◽  
Study Participants

Introduction: The dual objective of this study is to examine the perspectives of young adults toward advance directives (ADs) and their preferences related to life-sustaining treatment and care options. Methods: Participants include graduate students (n = 30) attending a university in New York State. Data were collected using a structured survey questionnaire and Medical Orders for Life-Sustaining Treatment (MOLST) form. Bivariate summary statistics were performed to address the study aims. Results: The mean age of study participants was 24 years, 60% were female, 60% white, and 27% Black. Most (87%) participants reported being comfortable discussing death and end-of-life care and preferring to make their own decisions. Under the circumstance of no pulse and/or not breathing, 87% want CPR. With a pulse and respiration, 96% want artificially administered fluids and nutrition, 90% want a trial period of intubation and/or mechanical ventilation, 67% want to be sent to a hospital, 67% want antibiotics, and 53% want no limitations on medical intervention. Conclusion: Our findings extend upon previous research by quantifying young adults’ specific beliefs, experiences, and preferences regarding advance directives and life-sustaining interventions. Young adults in our study preferred maximum medical interventions for life-sustaining treatment and care. Given the troubling trends in unintended injury (eg, car crashes and drug overdose) as the leading cause of death among young adults, they should be given an opportunity to understand the options and treatments available and should be encouraged to complete an AD.

scholarly journals Do young adults see value in advance directives?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 850-850
Author(s):  
Yuchi Young ◽  
Arianna Stone ◽  
Taylor Perre ◽  
Kuo-Piao Chung ◽  
Ya-Mei Chen
Keyword(s):  
New York ◽  
Young Adults ◽  
End Of Life ◽  
End Of Life Care ◽  
New York State ◽  
Healthcare Providers ◽  
Population Based ◽  
Life Care ◽  
Study Results ◽  
Attitude Toward Ads

Abstract Many Americans avoid end-of-life care planning; only 26% have completed an advance directive (AD). An AD promotes end-of-life care with dignity allowing individuals to make end-of-life treatment and care decisions before they are unable to do so. Previous studies related to ADs are focused on older adults with serious illness or people with functional/mental disability. The objective of this survey is to better understand young adults' knowledge of and attitude toward ADs and their preferences for ADs related to treatment and care options. Methods. Participants include graduate students (n=25) attending a state university in New York State (NYS). Data were collected using two ADs (Five Wishes; Medical Orders for Life-Sustaining Treatment (MOLST)) and one survey questionnaire. Summary statistics and multivariate models will be used to address the study aims. Results. Preliminary results show the average age was 23 years, 72% were female, 48% White, and 44% Black. The majority of young adults hadn’t completed an AD; however, their attitude toward ADs was positive; the majority believe it is important to have an AD prepared at their current age; and they believe young adults would willing to fill out ADs. Young adults can make difficult treatment and care decisions when the situation requires it. Conclusion. The study findings can be useful to policy makers, healthcare providers and other stakeholders in promoting population-based healthcare decision-making. Limitation. Participants were recruited from one university in NYS; thus, the study results may be generalized to a population sharing similar characteristics.

scholarly journals High Intensity of End-of-Life Care Among Adolescent and Young Adult Cancer Patients in the New York State Medicaid Program

Medical Care ◽  
2015 ◽  
Vol 53 (12) ◽  
pp. 1018-1026 ◽  
Author(s):  
Jennifer W. Mack ◽  
Kun Chen ◽  
Francis P. Boscoe ◽  
Foster C. Gesten ◽  
Patrick J. Roohan ◽  
...  
Keyword(s):  
New York ◽  
Young Adult ◽  
Cancer Patients ◽  
End Of Life Care ◽  
New York State ◽  
Adolescent And Young Adult ◽  
Life Care ◽  
Medicaid Program ◽  
York State ◽  
Young Adult Cancer

scholarly journals A Pro-Choice Response to New York’s Reproductive Health Act

Philosophies ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 15
Author(s):  
Bertha Alvarez Manninen
Keyword(s):  
New York ◽  
Reproductive Health ◽  
End Of Life Care ◽  
Human Life ◽  
New York State ◽  
Choice Response ◽  
Moral Permissibility ◽  
Voluntary Active Euthanasia ◽  
The Right ◽  
Pro Choice

On 22 January 2019, New York state passed the Reproductive Health Act (RHA), which specifies three circumstances under which a healthcare provider may perform an abortion in New York: (1) the patient is within twenty-four weeks of pregnancy, (2) the fetus is non-viable, or (3) the abortion is necessary to protect the patient’s life or health. The first one, that of abortion being accessible within the first twenty-four weeks of pregnancy, is not unique to New York, as many other states allow medical professionals to provide abortions during this time. The latter two have caused significant controversy because they detail certain circumstances in which abortions would be accessible after twenty-four weeks. This paper will focus on these latter two circumstances. I will first argue that any debate or discussion about (2) must go beyond the conventional debate about the ethics of abortion and incorporate, more appropriately, a discussion on euthanasia and the ethics of end-of-life care for nascent human life. In particular, it requires us to consider the morality of non-voluntary active euthanasia for non-viable fetuses, rather than just a discussion of the ethics of late term abortions. When it comes to (3), I will argue that assessing its moral permissibility actually raises some legitimate moral concerns, even from a reproductive rights perspective. On certain readings, it seems as if condition (3) would allow for the termination of a healthy fetus for reasons not related to the mother’s physical health or life. If this is the case, I argue, the right to an abortion would be construed as a right to fetal termination, rather than just fetal evacuation. However, I will argue that there are good reasons that pro-choice advocates should interpret the right to an abortion as a right to fetal evacuation instead of termination, and if this is the case, a woman should not be able to demand the death of a healthy fetus if ending the pregnancy safely via fetal evacuation would suffice.

scholarly journals Perceived Stress Levels and Associated Factors Among SARS-CoV-2-Affected Young Adults Under Home Isolation—A Cross-Sectional Study From Kerala, India

2022 ◽  
pp. 263394472110586
Author(s):  
Anjana Nalina Kumari Kesavan Nair ◽  
Jisharaj Vijayakumari Rajasekharan Nair ◽  
Siji Vincent Swarnabai ◽  
Reshma Rajan Sudha ◽  
Alice Metilda Mendez ◽  
...  
Keyword(s):  
Young Adults ◽  
Perceived Stress ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Stress Levels ◽  
The Mean ◽  
Study Participants ◽  
The Impact

Introduction The impact of SARS-CoV-2 is not only on physical health but also on mental health. This pandemic raised concerns of fear, anxiety, and stress among patients affected with the disease. Quarantine and home isolation might have created psychological distress and helplessness in patients due to social and economic reasons. This study aimed in assessing the level of perceived stress and factors associated with it among SARS-CoV-2-affected young adults who were under home isolation. Methodology A cross-sectional study was conducted among 147 SARS-CoV-2-affected young adults who were under home isolation during June 2021 to August 2021. A semi-structured proforma was created using KoBo Toolbox for humanitarian response for data collection. Perceived Stress Scale (PSS-10) was used for measurement of stress among COVID-19 patients. The questionnaire was shared in online platform. Data was analyzed using Statistical Package for Social Sciences version 23.0. Significance of association was tested using chi square test and independent sample t test. Logistic regression was done to predict the factors associated with perceived stress. Results Out of the 147 study participants, 56.5% were females and 43.5% were males. Symptoms were present in 94 (63.9%) of patients. The mean age of the study participants was 26 (10.5) years. The mean PSS score was 17.5 (6.4). Among the cases under home isolation, 24.5% had low stress levels, 68% had moderate stress levels, and 7.5% had severe stress levels. Feeling of loneliness during home isolation (odds ratio [OR]: 4.7, 95% confidence interval [CI] [1.9-11.63], P = .008), presence of elderly or under-5 children in the same house (OR: 15.45, 95% CI [2.03-117.5], P = .001), and presence of cough ( P = .05) were found to be significantly associated with higher PSS scores. Age and sleep were negatively correlated with stress score. Conclusion One-third of the study participants had moderate to severe levels of perceived stress. Age, sleep hours, presence of cough, presence of under-5 children or elderly in the same house, and feeling of loneliness during home isolation were found to be significantly associated with high perceived stress level scores.

Right to Refuse Life-Sustaining Treatment

PEDIATRICS ◽  
1988 ◽  
Vol 81 (2) ◽  
pp. 317-321
Author(s):  
RASA GUSTAITIS
Keyword(s):  
New York ◽  
Critically Ill ◽  
Ethical Dilemmas ◽  
New York Times ◽  
Medical Intervention ◽  
Parental Choice ◽  
Meaningful Life ◽  
Life Sustaining Treatment ◽  
Judicial Actions ◽  
Similar Development

Recent judicial actions expanding individual rights to refuse life-prolonging medical intervention serve to call attention to the absence of similar development regarding severely damaged, critically ill newborns. Whereas courts have provided guidelines that will allow adults to choose death when hope for meaningful life is lost, hopelessly ill infants continue to be treated aggressively, even in violation of their physicians' reasonable judgment and parental choice. Significant rulings that allow adults to refuse life-supporting treatment grow from the same perception as gives rise to the ethical dilemmas posed by severely damaged newborns: that it is inhumane, indeed morally indefensible, to prolong life when "the burden of maintaining a corporeal existence degrades the very humanity it was meant to serve" (The New York Times, Sept 12, 1986, p A10).

scholarly journals Factors Influencing Buprenorphine Prescribing among Physicians in New York State

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Leslie A. Marino ◽  
Aimee N. Campbell ◽  
Edward V. Nunes ◽  
Lloyd I. Sederer ◽  
Lisa B. Dixon
Keyword(s):  
New York ◽  
New York State ◽  
Prescribing Patterns ◽  
Implementation Support ◽  
Policy Makers ◽  
Practice Characteristics ◽  
Factors Influencing ◽  
The Mean ◽  
Simple Logistic ◽  
Common Barriers

Background. Increasing access to buprenorphine is an important strategy for curtailing the opioid epidemic. Research is needed to understand what facilitates prescribing among waivered physicians and how to increase the willingness and capacity to prescribe. This study describes prescribing patterns in a sample of buprenorphine-waivered physicians in New York (NY) in 2016 and examines factors influencing prescribing capacity among waivered providers. Methods. Surveys were mailed to a random sample of 300 physicians with DEA waivers to prescribe buprenorphine in NY which assessed demographics, practice characteristics, buprenorphine prescribing patterns, and barriers/facilitators to prescribing buprenorphine. Analyses include simple logistic regression to calculate the odds ratio, 95% confidence intervals, and p values, respectively, to examine differences in individual predictors among physicians that were actively prescribing buprenorphine and those that were not. Results. 91 physicians responded to the survey, and 65% indicated they were currently prescribing buprenorphine. The mean patient census among physicians waivered to prescribe to 30 patients was 9.6 (SD = 9.7, median = 5), and to 100 patients, it was 60.5 (SD = 38.9, median = 72.5). Common facilitators included access to psychosocial referrals and better reimbursement, while inadequate resources, lack of time, and prior authorizations were the most common barriers. Conclusions. In addition to increasing the number of waivered physicians, policy-makers should provide enhanced training and implementation support for waivered physicians to start prescribing and facilitate continued and expanded prescribing among those already doing so.

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