Death is a natural part of the life process. Death will occur, whether it occurs naturally, or not. Death is inescapable. The scenario this paper will discuss pertains to an elderly woman, named Alicia Foote, and her legal right to create and exercise a living will. Ms. Foote currently has dementia, and is experiencing a diminished quality of life due to her hypertensive vascular disease, dementia, and semi-comatose state. Ms. Foote, hereinafter “the patient”, while still competent, executed a living will, which conveys her medical wishes to her future physician(s). The physicians in charge of the patient have had diverging opinions on what the best course of action is for her treatment. The emergency physician, Dr. Jones has come to the …show more content…
See Cruzan v. Director, Missouri Dept. of Health, 497. U.S. 261, 284 (1990). Also see In re Guardianship of Browning, 568 So. 2d 4 (Fla. 1990). In the present case, the patient executed a Living Will while competent, and there has been no further indication that the document is void, ineffective, or otherwise not valid. The patient, by execution of this type of advanced directive, provides readers, most importantly, the court, with the clear and convincing evidence needed to support her wishes. See §765.302, Fla. Stat. (2015). Also see Cruzan v. Director, Missouri Dept. of Health, 497. U.S. 261, 284 (1990). Advanced directives are an important part of treatment plans for patients. These documents are executed and implemented in large part, to ensure that a patient’s wishes are fulfilled. Presently, the patient cannot enforce her wishes verbally, or otherwise, so both her physicians, and the court will look to her advanced directives in determining the treatment plan for the patient. It can be assumed that the patient executed her Living Will so that if a situation like the current one arose, her wishes would be know. Ethically speaking, her physician’s, most importantly, her primary physician, have an obligation to enforce such treatment plan as the patient …show more content…
Many ethical, moral, and legal ramifications influence and affect how this type of care is provided. Unfortunately, death is an inevitable part of life; however, death does not come without its own rights. The right to die, refuse medical treatment, and the rights to choose how end-of-life care can be given, or withheld, are significant individual rights which influence and effect the medical and legal professions. For years, these rights have been upheld through either the legislature, judicial opinion, or ethical committees. In the present case, it is not the intent, nor desire of the committee to rewrite the existing policies which dictate how to handle a situation such as this one. As already stated, the committee strongly urges the primary care physician to review the patient’s records, and find that the patient meets the criteria required to implement her pre-existing Living Will. The primary care physician should take into consideration the ethical and legal ramifications as defined and analyzed in the above opinion prior to drawing a conclusion. Death is a natural part of life, and with death, should come dignity. The patient has demonstrated her wishes, and it is now up to the primary physician to uphold the patient’s
As a result, life-sustaining procedures such as ventilators, feeding tubes, and treatments for infectious and terminal diseases are developing. While these life-sustaining methods have positively influenced modern medicine, they also inadvertently cause terminal patients extensive pain and suffering. Previous to the development of life-sustaining procedures, many people died in the care of their own home, however, today the majority of Americans take their last breath lying in a hospital bed. As the advancement of modern medicine continues, physicians and patients are going to encounter life-altering trials and tribulations. Arguably, the most controversial debate in modern medicine is the discussion of the ethical choice for physician-assisted suicide.
This ethical scenario presents an 86 year old female with numerous health issues and chronic illnesses. Mrs. Boswell’s advancing Alzheimer’s disease makes it extremely difficult to initiate dialysis, leading her physician to conclude a poor quality of life. The ethical dilemma portrayed in this case is between nonmaleficence and autonomy. Health care workers should focus on promoting the patient’s overall wellbeing and weigh the benefits and risks of the course of action, while also considering what the family declares they want done. Since the patient is deemed unable to make decisions, the goal is to collaborate with family, assess patient quality of life, address prognosis, and establish realistic care goals.
There are many legal and ethical issues when discussing the topic of physician-assisted suicide (PAS). The legal issues are those regarding numerous court cases over the past few decades, the debate over how the 14th Amendment of the United States Constitution comes into play, and the legalization vs. illegalization of this practice. The 14th Amendment states, “nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws” (U.S. Const. amend. XIV, §1). PAS in the past has been upheld as illegal due to the Equal Protection Clause of the 14th amendment of the constitution, but in recent years this same 14th amendment is also part of the reasoning for legalizing PAS, “nor shall any State deprive any person of…liberty” (U.S. Const. amend. XIV, §1). The ethical issues surrounding this topic include a patient’s autonomy and dignity and if PAS should be legalized everywhere. This paper is an analysis of the PAS debate and explores these different issues using a specific case that went to the supreme courts called Washington et al. v. Glucksberg et al.
No healthcare professional or hospital can force a person to make an advance directive if they do not want one. Although they are extremely encouraged, hospitals and doctors may not discriminate against anyone that does not have an advance directive. Advance directives are more so that the patient has a say in their end-of-life care even if they are unable to make the decisions at that time. It is helpful for doctors and other healthcare professionals because it allows them to provide better patient-centered care. If a person does not have an advance directive, the state of Indiana allows any member of the person’s immediate family or someone appointed by the court to make decisions for them. A person will get care more suitable for their personal beliefs if they write a living will or have a power of attorney.
Social Attitudes Survey noted that 78% of respondents believe that “the law should require doctors to carry out the instructions of a Living Will” (Park et al, 2007). These decisions become important once patients lose their mental capacity, are unconscious, or unable to communicate” (BMA, 2009). The Mental Capacity Act 2005 defines an “advance decision” as a decision made by a person 18 or over, when he or she has the capacity to do so. The implications of a Living Will, make the case against legalising assisted dying weaker. This is because if a person is legally allowed to set out which treatments they will or will not agree to, and can refuse life sustaining treatments by creating a legal document, then why shouldn’t an individual in extreme pain who is able to make the request at the time be able to ask for assistance in
America is a champion of the freedom of choice. Citizens have the right to choose their religion, their political affiliation, and make personal decisions about nearly every facet of their daily lives. Despite all of these opportunities, one choice society commonly ignores is that of deciding how one’s life will end. Death seems like a highly unpredictable, uncontrollable occurrence, but for the past 17 years, citizens of Oregon have had one additional option not offered to most Americans in the deciding of their end-of-life treatment. Oregon’s Death With Dignity Act (DWDA), passed in 1994, allows qualified, terminally-ill Oregon patients to end their lives through the use of a doctor-prescribed, self-administered, lethal prescription (Office of Disease Prevention and Epidemiology, n.d.). The nationally controversial act has faced injunctions, an opposing measure, and has traveled to the Supreme Court, however it still remains in effect today.
Imagine, if you will, that you have just found out you have a terminal medical condition. Doesn’t matter which one, it’s terminal. Over the 6 months you have to live you experience unmeasurable amounts of pain, and when your free of your pain the medication you’re under renders you in an impaired sense of consciousness. Towards the 4th month, you begin to believe all this suffering is pointless, you are to die anyways, why not with a little dignity. You begin to consider Physician-Assisted Suicide (PAS). In this essay I will explain the ethical decisions and dilemmas one may face when deciding to accept the idea of Physician-Assisted Suicide. I will also provide factual information pertaining to the subject of PAS and testimony from some that advocate for legalization of PAS. PAS is not to be taken lightly. It is the decision to end one’s life with the aid of a medical physician. Merriam-Webster’s Dictionary states that PAS is “Suicide by a patient facilitated by means (as a drug prescription) or by information (as an indication of a lethal dosage) provided by a physician aware of the patient’s intent.” PAS is considered, by our textbook – Doing Ethics by Lewis Vaughn, an active voluntary form of euthanasia. There are other forms of euthanasia such as non-voluntary, involuntary, and passive. This essay is focusing on PAS, an active voluntary form of euthanasia. PAS is commonly known as “Dying/Death with Dignity.” The most recent publicized case of PAS is the case of Brittany Maynard. She was diagnosed with terminal brain cancer in California, where she lived. At the time California didn’t have Legislative right to allow Brittany the right to commit PAS so she was transported to Oregon where PAS is legal....
One of the greatest dangers facing chronic and terminally ill patients is the grey area regarding PAS. In the Netherlands, there are strict criteria for the practice of PAS. Despite such stringencies, the Council on Ethical and Judicial Affairs (1992) found 28% of the PAS cases in the Netherlands did not meet the criteria. The evidence suggests some of the patient’s lives may have ended prematurely or involuntarily. This problem can be addressed via advance directives. These directives would be written by competent individuals explaining their decision to be aided in dying when they are no longer capable of making medical decisions. These interpretations are largely defined by ones morals, understanding of ethics, individual attitudes, religious and cultural values.
Advance directives might have many guidelines for patient’s preferences with regard to any number of life-affecting, or end of life situations, such as chronic disease or accident resulting in traumatic injury. It can include directions for other health situations, such as short-term unconsciousness, impairment by Alzheimer disease or dementia. These guidelines may consider do-not- resuscitate (DNR) orders if the heart or breathing stops, tube-feeding, or organ and tissue donation. The directive might name a specific person, or proxy, to direct care or may be very general with only basic instructions given for treatment in time of the incapacitation of a patient. Some states say that if you do not have a written directive, a spoken directive is acceptable.
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
The right to assisted suicide is a significant topic that concerns people all over the United States. The debates go back and forth about whether a dying patient has the right to die with the assistance of a physician. Some are against it because of religious and moral reasons. Others are for it because of their compassion and respect for the dying. Physicians are also divided on the issue. They differ where they place the line that separates relief from dying--and killing. For many the main concern with assisted suicide lies with the competence of the terminally ill. Many terminally ill patients who are in the final stages of their lives have requested doctors to aid them in exercising active euthanasia. It is sad to realize that these people are in great agony and that to them the only hope of bringing that agony to a halt is through assisted suicide.When people see the word euthanasia, they see the meaning of the word in two different lights. Euthanasia for some carries a negative connotation; it is the same as murder. For others, however, euthanasia is the act of putting someone to death painlessly, or allowing a person suffering from an incurable and painful disease or condition to die by withholding extreme medical measures. But after studying both sides of the issue, a compassionate individual must conclude that competent terminal patients should be given the right to assisted suicide in order to end their suffering, reduce the damaging financial effects of hospital care on their families, and preserve the individual right of people to determine their own fate.
In an effort to provide the standard of care for such a patient the treating physicians placed Ms. Quinlan on mechanical ventilation preserving her basic life function. Ms. Quinlan’s condition persisted in a vegetative state for an extended period of time creating the ethical dilemma of quality of life, the right to choose, the right to privacy, and the end of life decision. The Quilan family believed they had their daughter’s best interests and her own personal wishes with regard to end of life treatment. The case became complicated with regard to Karen’s long-term care from the perspective of the attending physicians, the medical community, the legal community local/state/federal case law and the catholic hospital tenants. The attending physicians believed their obligation was to preserve life but feared legal action both criminal and malpractice if they instituted end of life procedures. There was prior case law to provide guidance for legal resolution of this case. The catholic hospital in New Jersey, St. Clare’s, and Vatican stated this was going down a slippery slope to legalization of euthanasia. The case continued for 11 years and 2 months with gaining national attention. The resolution was obtained following Karen’s father being granted guardianship and ultimately made decisions on Karen’s behalf regarding future medical
...e outdated or inapplicable to the specific circumstances” (Schatz, 2010, 4). There are three different options of a healthcare proxy in a patient’s living will. First, the healthcare proxy does specify what is in the living will of their patient. Second, they must obey what is written in the living will and if any other decisions shall be made, the healthcare proxy has the authority to do so. Thirdly, the patient has written a living will but has disregarded it and turned to the healthcare proxy to make any decisions when it is necessary or when they seek fit to do so. Good communication skills, as well as specific requests, before they fall into ill health, with their caregivers and family will help simplify vast emotional issues for the ones of the patient left behind. This may also remove any hardship on the patient’s medical team that they would have to undergo.
The living will is the principle right by law in the United States for all citizens of adult age who are competent to control the course of treatment regarding their body. That includes surgery and the surgeon who must have the patient’s consent to operate, and the use of any life-sustaining treatment, the administration of any type of aggressive therapies, such as the kind used for cancer, and other terminal diseases once the patient has gone beyond medical ability to restore the patient to a decent quality of health. This is when the instruction of the patient’s desires in the living will is crucial. It instructs the physicians how to proceed with wishes of the patient, such as not allowing any prolonging of life sustaining treatment. The
Should a patient have the right to ask for a physician’s help to end his or her life? This question has raised great controversy for many years. The legalization of physician assisted suicide or active euthanasia is a complex issue and both sides have strong arguments. Supporters of active euthanasia often argue that active euthanasia is a good death, painless, quick, and ultimately is the patient’s choice. While it is understandable, though heart-rending, why a patient that is in severe pain and suffering that is incurable would choose euthanasia, it still does not outweigh the potential negative effects that the legalization of euthanasia may have. Active euthanasia should not be legalized because