Provisions for Implementing Decisions

Abstract

Protocols for the elective use of life-sustaining treatment establish a framework to promote the proper implementation of treatment decisions (Hastings Center, 1987; Kapp, 1987; Office of Technology Assessment, 1987; President’s Commission, 1983). Provisions for proper treatment plan implementation should: (1) establish treatment assumptions that safeguard against the unintended withholding of life-sustaining treatment; (2) maintain accountability of staff for decision making and the provision of treatment; (3) provide for accurate communication of treatment intentions; and (4) promote compliance with mandated procedures of outside agencies. Finally, protocols should provide for proper implementation and updating of the protocol itself.