{ "document_id": 16142, "page": 30, "width_pt": 612, "height_pt": 792, "rotation": 0, "pipeline_version": "paddleocr-vl-1.6+paul-48", "engine": "paddleocr_vl", "source_run_id": 16253, "item_count": 18, "counts_by_type": { "heading": 2, "link": 2, "list": 1, "list_item": 7, "text": 6 }, "build_ms": 2, "items": [ { "id": "p30.1", "order": 1, "type": "heading", "bbox": { "l": 69.6, "t": 718.08, "r": 293.76, "b": 703.44 }, "text": "Considerations Before Giving Consent", "attrs": { "block_label": "paragraph_title" }, "level": 3 }, { "id": "p30.2", "order": 2, "type": "text", "bbox": { "l": 69.36, "t": 701.28, "r": 542.16, "b": 642.72 }, "text": "When determining whether to give consent or approval for a treatment of any kind, you should consider the wishes of the IP and their loved ones. However, if the wishes of the loved ones are not in the best interests of the IP, or conflict with the express wishes of the IP, you will need to act according to the IP's wishes and best interest, instead of those of the IP's loved ones." }, { "id": "p30.3", "order": 3, "type": "text", "bbox": { "l": 76.8, "t": 624.48, "r": 532.56, "b": 595.92 }, "text": "Before consenting to treatment, you must ensure you have all the information needed from medical or other professionals and understand:" }, { "id": "p30.4", "order": 4, "type": "list", "bbox": { "l": 77.28, "t": 588.54, "r": 366.72, "b": 475.44 }, "text": "", "attrs": { "item_count": 7 }, "children": [ { "id": "p30.4.1", "order": 5, "type": "list_item", "bbox": { "l": 78, "t": 588.54, "r": 223.2, "b": 572.88 }, "text": "The suggested treatment" }, { "id": "p30.4.2", "order": 6, "type": "list_item", "bbox": { "l": 78.24, "t": 572.22, "r": 237.84, "b": 557.04 }, "text": "Alternate treatment options", "marker": "•" }, { "id": "p30.4.3", "order": 7, "type": "list_item", "bbox": { "l": 78.24, "t": 556.02, "r": 195.36, "b": 541.2 }, "text": "Intended outcomes" }, { "id": "p30.4.4", "order": 8, "type": "list_item", "bbox": { "l": 77.52, "t": 539.7, "r": 366.72, "b": 524.4 }, "text": "Possible complications or side-effects of the treatment" }, { "id": "p30.4.5", "order": 9, "type": "list_item", "bbox": { "l": 77.28, "t": 523.38, "r": 304.32, "b": 508.32 }, "text": "Potential effects of not starting treatment" }, { "id": "p30.4.6", "order": 10, "type": "list_item", "bbox": { "l": 77.76, "t": 507.18, "r": 260.88, "b": 491.52 }, "text": "How long the treatment will take", "marker": "-" }, { "id": "p30.4.7", "order": 11, "type": "list_item", "bbox": { "l": 77.76, "t": 490.86, "r": 282.96, "b": 475.44 }, "text": "How the treatment will be monitored", "marker": "-" } ] }, { "id": "p30.5", "order": 12, "type": "heading", "bbox": { "l": 70.32, "t": 444.72, "r": 268.8, "b": 428.16 }, "text": "End-of-Life Decision-Making", "attrs": { "block_label": "paragraph_title" }, "level": 3 }, { "id": "p30.6", "order": 13, "type": "text", "bbox": { "l": 68.64, "t": 411.6, "r": 542.88, "b": 352.8 }, "text": "It can be difficult to make decisions regarding end-of-life care on behalf of an IP. First, you must look to any advance planning documents the IP completed prior to their incapacitation such as a power of attorney, advance health care directive, Do Not Resuscitate order (DNR), or Pennsylvania Orders for Life Sustaining Treatment (POLST)." }, { "id": "p30.7", "order": 14, "type": "text", "bbox": { "l": 68.64, "t": 345.12, "r": 542.4, "b": 271.44 }, "text": "If the IP is diagnosed with a terminal condition, they may need additional or different services. It is important for you to share any advance planning documents with their doctors. Also consider any preferences the IP communicates after the diagnosis, and what you know of their prior values or religious beliefs. Remember, you must honor their wishes to the extent possible, even if they conflict with your own beliefs or preferences." }, { "id": "p30.8", "order": 15, "type": "text", "bbox": { "l": 68.64, "t": 263.52, "r": 542.64, "b": 175.68 }, "text": "When it becomes necessary to make decisions about withdrawing or withholding life-sustaining treatments, you must first abide by the IP’s written or spoken preferences stated prior to their incapacity, including those documented in advance planning documents. If that is not an option and you do not know what they would be likely to choose based on their beliefs and the situation, then you must base your decision on what a “reasonable person” would do given the IP’s specific circumstances and seek court approval prior to acting. xxxxvii", "children": [ { "id": "p30.8.1", "order": 16, "type": "link", "bbox": { "l": 354.48, "t": 192.792, "r": 357.192, "b": 176.736 }, "text": "", "attrs": { "target_page": 90, "action_type": "/GoTo" } } ] }, { "id": "p30.9", "order": 17, "type": "text", "bbox": { "l": 68.4, "t": 168, "r": 542.16, "b": 95.28 }, "text": "The opinions of the IP’s loved ones should be considered as well, but it is important to weigh any financial or other motives individuals may have in their suggestions. In these situations, you may also want to get a second opinion from another doctor, discuss the situation with the IP’s nursing and direct care staff, and consider opinions of an ethics committee or review board, if possible.xxxviii", "children": [ { "id": "p30.9.1", "order": 18, "type": "link", "bbox": { "l": 134.76, "t": 111.449, "r": 136.577, "b": 100.692 }, "text": "", "attrs": { "target_page": 90, "action_type": "/GoTo" } } ] } ], "excluded_furniture": { "first": [ { "id": "p30.f1", "order": 19, "type": "header", "bbox": { "l": 69.84, "t": 754.8, "r": 231.6, "b": 742.32 }, "text": "Pennsylvania Guardian Handbook", "attrs": { "block_label": "header" } } ], "last": [ { "id": "p30.f2", "order": 20, "type": "text", "bbox": { "l": 526.8, "t": 70.8, "r": 541.2, "b": 59.28 }, "text": "19", "attrs": { "block_label": "number" } } ] } }