surrogate decision-making authority
A 72 year old woman was admitted to the Neurological Intensive Care Unit following a cerebral hemorrhage which left her with severe brain damage and ventilator dependent. One year before this event, the patient and her husband had drawn up “living wills” with an attorney. She was diagnosed by her treating physician as being in a permanent unconscious condition. The patient’s living will specified that the patient did not want ventilator support or other artificial life support in the event of a permanent unconscious condition or terminal condition.
The patient’s husband is her legal next of kin and the person with surrogate decision-making authority. When the living will was discussed with him, he insisted that the patient had not intended for the document to be used in a situation like the present one. Further discussion with him revealed that he understood that the patient would not be able to recover any meaningful brain function but he argued that the living will did not apply because her condition was not imminently terminal. He further indicated that he did not consider his wife to be in a permanent unconscious condition. The immediate family members (the couple’s adult children) disagreed with their father’s refusal to withdraw life support.
The treatment team allowed a week to pass to allow the husband more time to be supported in his grief and to appreciate the gravity of his wife’s situation. Nevertheless, at the end of this time, the husband was unwilling to authorize withdrawal of life support measures consistent with the patient’s wishes as expressed in her living will.
List and discuss the three most important ethical/legal issues in this scenario [Just three]. Why are they legal /ethical issues? Be sure and define the concepts you discuss. As a health care provider, how would you have handled this situation and why?
Use as headings in your paper the three legal/ethics issues you pick to discuss.
You are on the honor system not to discuss or consult with any students or other individuals about this paper. You may use the information we have discussed in the class, the articles in the class, and the article I have furnished below but you may NOT do internet research on this topic.
Background info to get your mind going and principle article to use to evaluate the facts in the scenario. This article is more than a sufficient aid to help you determine the three most important issues and also assist you in formulating your discussions for each issue.
Relationships: I. clinical ethics, law & risk management
In the course of practicing medicine, a range of issues may arise that lead to consultation with a medical ethicist, a lawyer, and/or a risk manager. The following discussion will outline key distinctions between these roles.