Care Management & Patient Rights

Advance Directives

Physicians must be aware of their patients’ intent regarding end of life care. If a patient has provided an Advance Directive to the hospital, a copy will be in the medical record chart. If a patient has not completed these documents and wishes to do so, that may be arranged while in the hospital. For more information contact the Care Management Department of St. Dominic’s at extension 6768.

Beginning of Life

St. Dominic Hospital fosters respect for marriage and the family and witnesses to the sanctity of human life from the moment of conception. St. Dominic’s provides prenatal, obstetric and postnatal services consistent with these values. Because of our respect for human dignity from the moment of conception, St. Dominic’s does not provide abortion services. Prenatal diagnosis is permitted when the diagnosis can provide information to guide preventative care for the mother or pre- or postnatal care for the child. Direct sterilization of men or women is not permitted at this hospital.

End of Life

St. Dominic’s affirms the belief that life is a gift from God to every human person. Each person is treated with dignity. Our duty is to preserve life except when treatment is futile and serves only to prolong suffering. In the instance of dying, one may reject life-sustaining procedures because they are not beneficial and/or are excessively burdensome. However, “assisted suicide and euthanasia are never morally accepted options” (Ethical and Religious Directives of Catholic Health Facilities, 2009). Care of the dying person is loving care, and all aspects of care are guided by concerns for the patient’s comfort, dignity, and autonomy during the final stages of life.

When the patient dies, the attending physician is notified, and he/she may elect to notify the family. Otherwise, the nurse will notify the family. The attending physician is responsible for pronouncing the body and signing the death certificate.

Brain Death

Mississippi Law 41-36-3 stipulates that an individual, who has sustained irreversible cessation of all functions of the entire brain, including the brain stem, is dead. The responsibility for determination of brain death rests with the patient’s attending physician. During the period of observation in a patient in whom brain death is suspected, the hospital’s guideline regarding DNR orders is fully applicable. After a patient has been declared brain dead, the DNR guidelines no longer apply.

Ethical and Religious Directives (ERD)

Ethical and Religious Directives for Catholic Healthcare Services promote and protect the truths of the Catholic faith as those truths are brought to bear on concrete issues in health care.

Organ and Tissue Donation

Mississippi Organ Recovery Agency (MORA) is the federally designated organ procurement organization for central and southern Mississippi. St. Dominic Hospital complies with this federal designation by working cooperatively with MORA for the procurement of organs. St. Dominic’s may have contractual relationships with other banks for the procurement of tissue and ocular tissue respectively. These agreements do not interfere with organ procurement.

All deaths (brain death and cardiac death) and imminent death at St. Dominic Hospital are referred through the Donor Referral and Information line at 1-800-362-6189. The call is made within the time requirements jointly agreed to by St. Dominic’s and MORA, ideally within one hour of meeting referral criteria for imminent death and/or cardiac time of death.

For further information see, refer to the Reference Manual located on Dominet.

Death-autopsy

St Dominic Hospital honors the patient’s family request for an autopsy and/or will be notified of the need for an autopsy by the physician or nurse. This process will be handled with respect and dignity. The only one who can give written permission for the autopsy is the patient’s immediate next of kin, or authorized family representative.

For complete procedures refer to the Reference Manual located on Dominet.

Palliative Care

Palliative Care is an interdisciplinary approach to care which focuses on quality of life of patients and their loved ones facing serious, progressive, or life-threatening illness through focused symptom management, support of emotional, spiritual, psychosocial and cultural needs, and maximizing function status.

The core team members include the palliative care coordinator/RN, social worker, and pastoral care associate. The physician identifies an inpatient who may benefit from the support of the palliative care team and an order is needed to consult the team.

Pain Assessment and Management

Patients should be kept as free of pain as possible especially if the patient is dying. This will help the patient die comfortably and with dignity. St. Dominic’s recognizes that patients have the right to pain management and has guidelines and protocols to properly assess and to effectively manage pain which ensure that:
•Pain is assessed initially and periodically
•Pain is addressed appropriately in accordance with the care, treatment, and services provided
•Pain assessment management education is provided for all relevant caregivers
•Education is available for patients and families regarding the process of pain management as well as potential limitations and side effects
•There is sensitivity to personal, cultural, spiritual and ethnic beliefs in communication with the patient about pain management

Patient Rights and Responsibilities

Patients have the right to:
•Respect, compassion and dignity
•Receive effective communication
•Know the identity & professional status of the persons responsible for delivery of care
•Be involved in decisions about treatment and care
•Have family member and their own physician notified promptly of admission to the hospital

Patients have the responsibility to:
•Provide adequate and complete information about present and past illnesses, hospitalizations, and medications
•Inform caregivers of perceived risks in their care and unexpected changes in their conditions
•Follow the care, treatment and service plan developed and ask questions when the care is not understood
•Understand that unfavorable outcomes may be experienced when they do not follow the care, treatment and service plan
•Follow the facility’s rules and regulations
•Be considerate of the staff of the facility and their property as well as other patients and their property
•Fulfill financial obligations promptly