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Connections Journals are opportunities for students to identify and analyze some connections among key course components. Over the last 3 weeks of the course, the modules have introduced some key con

Connections Journals are opportunities for students to identify and analyze some connections among key course components. 

Over the last 3 weeks of the course, the modules have introduced some key concepts, such as surrogate decision making, advanced care planning, advanced directives and end-of-life decision making.

For Connections Journal 2, write an approximately 250-word essay (about one page double-spaced) in which you highlight connections between these concepts. (You may also note connections of these key concepts with those concepts covered in the first 3 weeks). Here are some examples of possible connections:

  • Foundation(s): Values presupposed by a key concept
    • For example, what values undergird the substituted judgment standard for surrogate decision making? Do different values undergird the best interest standard?
  • Distinct concepts: Concepts that can be differentiated from a key concept but may share some similarities.
    • For example, what are the similarities and differences between an advanced directive (AD) and a POST?
    • For example, do different types of surrogate decision makers have different degrees of freedom to decide for the patient they are responsible for?
    • For example, how does decision making for another differ from deciding for yourself?
  • Component parts: The relationship of the parts to the whole.
    • For example, how do oral communication of future care preferences and the reasons for them, written advance directives and POST forms work together as parts of an advance care plan?
    • For example, what topics are normally addressed in an AD or in a POST?

If you are a visual learner, you may include a concept map diagram with your essay. It might help you to draw a diagram with 3 big circles—one for surrogate decision making, another for advance directives and other advance care planning documents, and the last specifically for end-of-life decision making. Those are the three big concepts covered by this journal. Inside those circles you could add the key components of those concepts. You might think of some visual way to call attention to shared elements. 

If you do something like that, you should be able to see some connections. For example, if decision-making capacity is lacking, then the section of many advance directives dealing with appointment of a healthcare agent would take effect. If an agent is deciding for a previously capacitated adult, then that adult’s past statements and values should normally guide surrogate decision making.

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