In this paper, I will be arguing a that in the Please Let Me Die case, the patient did not give informed consent to rejecting treatment due to a variety of factors. In summary, the patient was a 25-year-old male named Dax Cowart who suffered severe burns over 65% of his body after a propane gas explosion. He had several fingers amputated and his right eye removed after he was stabilized. He was discharged with minimal use of his hands, totally blind, and needed assistance with daily activities. He asked that treatment be discontinued throughout his hospital stay and rehabilitation, but his request was denied because his physicians deemed him not competent. I believe he was not competent because of his injuries; as is said about many patients …show more content…
Competency is the idea of being of sound mind, and being able to make rational decisions in a situation. In conjunction with competency is decision-making capacity. DMC is a continuum on which the patient’s ability to make a decision at a specific time is measured . A patient has DMC when they can understand all the information on their condition and the consequences of whatever choice they decide to make. In the case of those who are incompetent, physicians must use substituted judgement; treatment should be in line with what the patient would prefer if they were competent . At the time of his accident, I believe Dax was incompetent, and therefore unable to give informed consent about rejecting treatment for a plethora of reasons. The most obvious reason is that he was in immense amounts of pain. Pain has a fascinating ability to completely cloud the mind of all other rational thought. In the case of burn victims like Dax, they experience extreme amounts of pain for an extended period; as the process of recovery starts, daily bandage changes and baths aggravate the burns. Moreover, pain like that is treated with very strong medications, which have a myriad of side-effects ranging from mild sedation and confusion to hallucinations . If Dax was experiencing the pain and side-effects most burn patients do, then he was not able to think rationally, and therefore was incompetent. Because competency is a requirement for informed consent, his physicians were right to deny his request to stop
This is a fascinating case because it presents the distinction between a patient’s right to refuse treatment and a physician’s assistance with suicide. Legally, Diane possessed the right to refuse treatment, but she would have faced a debilitating, painful death, so the issue of treatment would be a moot point. It would be moot in the sense that Diane seemed to refuse treatment because the odds were low, even if she survived she would spend significant periods of time in the hospital and in pain, and if she didn’t survive she would spend her last days in the hospital. If Diane were to merely refuse treatment and nothing else (as the law prescribes) than she would not have been able to avoid the death which she so dearly wanted to avoid.
Real-life heroes these days are firemen, police officers, emergency room medics. However, there are many stories of everyday people who end up hailed as heroes. In the novel A Lesson Before Dying by Ernest J. Gaines, the main characters do not follow any of the typical ‘hero’ professions. In a small American community, Jefferson, a young black man, has just been sentenced to death for a crime he never committed by an all-white jury. His former schoolteacher Grant Wiggins is forced to visit him by his aunt Tante Lou, who hopes that Grant can teach Jefferson some dignity before he faces the electric chair. Through the actions of Jefferson and Grant we can determine whether or not they are heroes to the African-American community which, after years of suppression and apartheid, is so in need of strong idols to look up to.
Patients are ultimately responsible for their own health and wellbeing and should be held responsible for the consequences of their decisions and actions. All people have the right to refuse treatment even where refusal may result in harm to themselves or in their own death and providers are legally bound to respect their decision. If patients cannot decide for themselves, but have previously decided to refuse treatment while still competent, their decision is legally binding. Where a patient's views are not known, the doctor has a responsibility to make a decision, but should consult other healthcare professionals and people close to the patient.
The major implication of this decision is that each state decides the type of evidence required to withhold or withdraw medical treatment from an incompetent patient. The state ...
treatment should be further assessed. Due to shock and pain a patient may have a lapse in judgement as to what they truly want for care. One morally relevant detail, when it comes to Dax’s case, it was about ten months of begging to be allowed to die as he was forced to undergo excruciatingly painful and invasive procedures. During this time the doctors should have disregarded their want to be a ethically virtuous character, and instead advocated what is wanted for the patient. If the doctors would have followed deontological ethics and listened to Dax, he would not have had to live forcibly blind and disabled. This wrongdoing by the doctor’s made Dax not able to live the quality in life in which he desired. The majority of the wrongdoing that
Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
Any act done or decision made on behalf of an individual deemed to lack the capacity (following a capacity assessment), must be done in their best interests, this can cover financial, health and social care decisions.
Emilio is terminally ill and is under the care of the Children’s Hospital in Texas. He is placed on life support by a respirator and is given pills causing the child to spend majority of his time in the pediatric intensive care unit unconscious. Showing no signs of improvement, the physician has requested the parents look for another hospital willing to continue aiding Emilio within a period of 10 days. Under the Texas “futile-care” law, the hospital’s ethics committee can, “declare the care of a terminally ill patient to be of no benefit,” allowing them to terminate care after a given time period. (Moreno, Sylvia. Case Puts Futile-Treatment Law Under a Microscope.
According to the NICE (2015) health and social care professionals should always seek valid consent from people with dementia. This should entail informing the person of options, and checking that he or she understands, that there is no coercion and that he or she continues to consent over time. If the person lacks the capacity to make a decision, the provisions of the Mental Capacity Act 2005 must be followed. The nurse assessed the patient capacity and ensured that the decision made was in the best interest of the patient. The doctor uses specialist knowledge and experience and clinical judgement, and the patient’s views and understanding of their condition, to identify which investigations or treatments are likely to result in overall benefit for the patient (GMC, 2008). They took into consideration how the decision made will benefit Jean. After carrying out a full assessment, it was clear that Jean lack capacity and was therefore place under the mental capacity act
One of the many concerns is allowing incompetent individuals making this irreversible decision, which is why, “all have agreed that this end-of-life option should apply on to competent individual’s”(113). In addition, people opposed to this method argue that patients demanding this process are suffering from depression and not able to make decisions; yet, Rosenfled explains that practitioners most ensure that patients who consent to this medical intervention do it voluntarily, knowingly and
Though these legislative guidelines deal with the rights of a patient to refuse current medical treatment, ...
A divergent set of issues and opinions involving medical care for the very seriously ill patient have dogged the bioethics community for decades. While sophisticated medical technology has allowed people to live longer, it has also caused protracted death, most often to the severe detriment of individuals and their families. Ira Byock, director of palliative medicine at Dartmouth-Hitchcock Medical Center, believes too many Americans are “dying badly.” In discussing this issue, he stated, “Families cannot imagine there could be anything worse than their loved one dying, but in fact, there are things worse.” “It’s having someone you love…suffering, dying connected to machines” (CBS News, 2014). In the not distant past, the knowledge, skills, and technology were simply not available to cure, much less prolong the deaths of gravely ill people. In addition to the ethical and moral dilemmas this presents, the costs of intensive treatment often do not realize appreciable benefits. However, cost alone should not determine when care becomes “futile” as this veers medicine into an even more dangerous ethical quagmire. While preserving life with the best possible care is always good medicine, the suffering and protracted deaths caused from the continued use of futile measures benefits no one. For this reason, the determination of futility should be a joint decision between the physician, the patient, and his or her surrogate.
A one hundred year old man is in a hospital suffering from excruciating pain, that is undeniable to live with. Should he have the right to attain a doctor to end his misery by just a click of a button? As a widening topic of discussion across the world, assisted suicide has been around for ages. Assisted suicide is a popular subject, that can be depicted on multiple types of television network shows. It is a controversial medical and ethical issue mainly based on the question of whether, medical practitioners should be authorized to help patients determine the time and the environment of their death. This practice is usually physician-assisted suicide. The term physician assisted suicide, describes any case,
As medical procedures and techniques have become more advanced, doctors are able to do much more to try and save a patient's life (Warriach). In some cases, however, this process is only delaying the inevitable and causing the patient even more suffering. If euthanasia were legal, patients could willingly choose to end this long process of torment, specifically in terminal cases where both would lead to the same result: death. In a hospital, a patient's life gets dragged on despite the condition by medical tools and devices such as respirators (Warriach). The only way to cease the patient’s anguish is by ending all means of life support. If euthanasia were presented as an option, it would save the patient, along with their family, from immense pain and
Autonomy (independence and the right of self-determination) is certainly valued in modern society and patients do, and should, have the right to accept or reject medical treatment. However, those who favor assisted suicide claim that autonomy extends to the right of a patient to decide when, where, how and why to die