This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. Describe advanced directives and healthcare proxies
2. Discuss the issues and implications related to state laws that may invalidate a pregnant woman’s advanced directives
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.
Faculty: Susan J. Gross, MD, receives consulting fees from Genoox, Inc., and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from July 6 2018 through July 6 2020, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
Living wills or healthcare directives are legal documents that express your wishes regarding medical care and life sustaining measures if you should become incapacitated. A designated person or healthcare proxy is a specific person to whom you give authority to make medical decisions for you in the event you are unable to express your preferences about medical treatment. Generally, the two documents are completed together but sometimes not. One would think that once a woman has expressed her wishes in writing that her wishes would be followed even if she were pregnant.
Idaho along with Alabama, Indiana, Kansas, Michigan, Missouri, South Carolina, Texas, Utah and Wisconsin, however, have laws that invalidate the directives if a woman is pregnant. Four women in Idaho have filed suit through Legal Voice and Compassion & Choices to have the law overturned. The lawsuit alleges that the Idaho law violates the United States Constitution’s guarantees of due process and equal protection of the law, because a pregnant woman’s right to choose if she wants life-sustaining measures is taken away from her. Second, under the law, a pregnant woman cannot designate her health care agent. Third, because of the law, the effectiveness of the health care directives of all women of childbearing age in Idaho is questionable until each woman’s pregnancy status is determined. Finally, women will be forced to have life-sustaining treatment for the duration of their pregnancies against their wishes.
This scenario occurred in 2014 when a Texas hospital kept a brain-dead pregnant woman on a ventilator. She had expressed to her husband and parents her wishes not to be machine dependent under any circumstances. She and the 14-week-old fetus had been deprived of oxygen for at least one hour. It took a lawsuit for the Texas hospital to finally remove the woman from life support.
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This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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