Case Study: Georgia Euthanasia

- Confirmed with 3rd party what needs to be included in the email and foreshadowed when they will receive it.

Since Oregon legalized physician assisted suicide for the terminally in 1977, more than 700 people have taken their lives with prescribed medication, including Brittany Maynard (NPR Staff, 2014). After, months of suffering from debilitating headaches, 29 year old Brittany Maynard learned that she had brain cancer (Maynard, 2014). Because her tumor was so large, doctors prescribed full brain radiation. With this treatment, the hair on her scalp would have been singed off, her scalp would be left covered with first-degree burns, and her quality of life would be gone (Maynard, 2014). Brittany began to research death with dignity, an end-of-life option for mentally competent, terminally ill patients with a prognosis of six months or less to live.

​The current legislation has caused issues for many Australians. This is illustrated in court in 2009, with then 49 year Christian Rossite. Christian Rossite was a quadriplegic after an automotive accident, and had asked his care provider if they would remove his PEG tube (feeding tube) from him, unsure if it was legal or not the care provider called on the Chief Justice in Western Australia, Wayne Martin who ruled in favour of Christian Rossite. Wayne Martin stated that Christian Rossite was ‘entitled to instruct his cares to remove a feeding tube from his stomach’ (2009, Martin), causing Christian Rossite to willingly starve to death. During this process Christian Rossite was reassured that the option to return to the PEG tube (feeding tube) was available, but chose to continue. Christian Rossite died from a chest infection soon after. His brother was quoted saying ‘Death I suspect comes as quite a relief for Christian’ (2009, Rossite), as Christian was also quoted saying ‘I have no fear of death- just pain. I only fear pain.’ (2009, Rossite). Christian Rossite died suffering, in pain from not only starving, but also a chest infection, this could have been prevented if there was sufficient legislation to allow Christian Rossite to die with peace.

The recommendation I am suggesting would include a singed “Do Not Resuscitate-DNR” agreement from Margie Whitson. Her legal guardian notified of her request and Hospice be contacted. This would be in leu of a possible health issues that would arise in the future. And with this in place, her wishes can be granted. Margie Whitson has lived a long full filled life and all of her family is deceased. She has come to terms with all the setbacks in her life and now wishes to just stop her suffering.

The primary goal of the healthcare providers in the Cruzan case was to provide medical care to prevent the death of a patient. “When a patient’s prognosis for meaningful survival is poor, there is a change in focus from restrictive care to palliative care” (Lones, M., 2015). Cruzan’s condition did not allow for palliative care, but the medical staff placed her on life support to prolong her life. The conflict arose between the family and the medical staff due to there was no documentation indicating the patient’s wishes. Cruzan did not have an advanced directive or living will to assist with the end of life decisions that were left up to the hospital and her parents. Advance directive document the decisions for medical care for terminal

Secondly, the patient should be capable of making and communicating health care decisions for him or herself. Thirdly, the patient must be diagnosed with a terminal illness that will lead to death within six months.  Interested patients must also provide the request for termination in writing to the physician. In addition, physicians are expected to inform patients to alternative means of care including hospice care and other medications. Only after precautions evaluation, the laws then permit patients to make the ultimate life ending decision.

Throughout the end season episodes of the television show Private Practice, there is an episode that presents euthanasia and does a great job of explaining an ideal situation that it could appear in. Amelia's friend, Michele, comes back from Italy, and out of what seems nowhere, asks Amelia to help her commit suicide. This act of asking somebody to assist in committing suicide is euthanasia, which can be expanded into so many different directions. Suicide itself can be expanded into many different judgements, some of those come from the Stanford Encyclopedia of Philosophy. It basically explains how there will always be so many varieties of opinions on suicide and there will most likely always be these many conflicting ideas.

By using this article, it will provide reasons why a patient seeks assisted suicide when facing a terminal diagnosis, with 6 months or less to live. It offers the physician perspective on assisting terminal patients at the end of their life span. An explanation of the Death with Dignity Act provides an example of legislature in the United States addressing this controversial subject.

“It is important for all staff to know what it is that the person has asked for” when dealing with patients under end-of-life care (Sander, 2014, p.96). Sander (2014) suggests that staff must first consider the wishes of the person who is dying over the family wishes. Once the patient’s wishes are considered first, then the staff can focus on the family who will be affected by the treatment and care of their loved one (Sander, 2014). After first looking to the patient’s wishes and then family wishes, the staff must consider staff and other residents’ experiences (Sander, 2014). Considering all those factors in that order promotes what Sander (2014) calls a good death. The administrator should have spoken to both Ann and John. Both are trusted persons of interest that Mrs. Smith established during her competent days. Both health proxy and durable power of attorney are important decisions makers. The health proxy makes healthcare decisions for incompetent patients (Pereira, 2013). Durable power of attorney assists communications between medical team and family members (Pereira, 2013). This assures there is respect for the patient’s values and expressed wishes (Pereira, 2013). The administrator did not value the patient’s wish. The administrator did not utilize Mrs. Smith’s trusted

In addition to advance directives, there are other decisions involving end of life care that people should think about and discuss with their loved ones. These are decisions are around the ‘how’ and ‘where’ that people wish to die. These types of measures may be touched on in one’s advance directives, but may not go into great detail. If diagnosed with a terminal disease or if the end of life is imminent, one should decide on the type and amount of treatment they receive. With death as a certainty, most people turn toward either palliative care or hospice

This film explains the legal role of advance directives in end of life issues. An advance directive is “a written document directing how medical decisions are to be made in the future when the patient lacks decisional capacity and is unable to decide and choose” (Hanlon, End of Life Issues, Slide 28, Bullet 1). All three of the cases demonstrate the importance in filling out some form of directive. When there is nothing to go off of, it makes decisions extremely tough for families and medical providers. Having legal documentation of patient wishes helps understand what treatments they would or would not consent to. In cases like

With an increasing aging population and growing numbers of individuals with chronic conditions, it is important for individuals to prepare for end-of-life care. An Advance Directive is a defined as a “legal document that provides data to critical care staff about patients’ wishes, especially when critical illness decreases decision-making ability” (McAdam, Stotts, Padilla, and Puntillo, 2005). An Advance Directive also allows for better communication between the patient and doctor, and preserves the autonomy of patients. It may also alleviate one’s family from any possible burden of uncertainty of one’s wishes. It provides guidance, which may avert arguments with family members concerning treatment choices (Cedars Sinai, 2015). The Patient

Ethical dilemma may also arise in cases where a patient may feel their right to DNR should be carried out when giving direct order. The DNR process, however, is required to be documented by a physician. Andrew Putnam (2003) presents a case where an eighty-eight year old patient’s code status was DNR; “However, the patient has never signed formal advance directive statement or assigned durable power of attorney for her health care to anyone.” (Putnam, 2003, 2025) Ethics can be simply stated as doing the right thing (Roberts, 2002, 242); but in this case ethics is questioned because the physician was faced with the decision to carry out the wishes of the patient or to make a decision based on legality. In this case, it may have been morally right to carry out the wishes of the patient who wanted DNR orders carried out, but it may have been the right choice to do the legal thing and not carried out due to lack of signed documentation.

Autonomy can override beneficence when life-support is withdrawn (Prozgar, 2010). In addition, when a physician takes the position of withdrawing life-supporting equipment, the principle of non-maleficence is severed. Since helping patients die violates the physician’s virtue of duty to save lives,” distributed justice is served by releasing a room in the intensive care unit for a patient who has a higher chance of resolving their medical problems (Pozgar, G. 2010). There are so many inflict fuzzy gray areas and ideas about conflicting DNR policies that political disputes had to go to the courts to sort out the issues legally.

Such a controversial topic as euthanasia and physician assisted suicide obviously brings about both proponents and opponents. When it comes to the case of a terminally ill person who is fully competent, how can one say no to his desire in having