Legal And Ethical Issues In Health Care

After reading your post and many of the colleague in the class, most agree that is not professional to disregard the conversation that the family was having. Although the patient wishes were not to remain on life support and had a document to prove it he also fail to have a proxy to carry one his whishes. The Health Care Proxy is a simple document, legally valid in many states, which allows a person to name someone (an "agent") to make health care decisions their behalf if they are unable to make or communicate those decisions. (Society, 2015).

McDonald and McIntyre (2014) explain there are four ethical principles, and all of them are involved in the case scenario. Because the primary physician assumed that the client did not have the capability to make rational decision in regard to his own DNR status, the physician disregarded this patient’s autonomy (Laurentian University, n.d; McDonald & McIntyre, 2014). On the other hand, if the physician continued to treat the patient’s disease appropriately as patient’s wish, the patient’s autonomy is partially supported (Laurentian University, n.d; McDonald &

A patient barrier might include having limited knowledge surrounding life-support systems and treatment options, thereby hindering their ability to fully comprehend or demand certain interventions. Good counseling is therefore essential to overcoming this barrier in implementing the patient’s true and best wishes (Kroning, 2014, p. 222). Another barrier in implementing advance directives concerns the role and influence of family members and the patient. There may be discordance between the desires of the patient and family, which can result in serious debate and tension if not addressed and taken into consideration. Physicians still may have reservations, as certain demands made by the patient may raise ethical concerns in the future, if the provider feels the interventions being done are no longer medically appropriate.

The nurse in the case study is faced with an ethical and professional, dilemma. How can she be an advocate for her patient Mr. E? Dr G. is proceeding on a course of action or plan of care that is directly contrary to the patients advance directive and his verbalized objections to the course of treatment proposed by the physician and that is concerning for her. There are multiple issues to consider. For the nurse, she needs to think about her code of ethics, her scope of practice and the legal issues regarding advance directives and Durable Power Of Attorney (DPOA). She also needs to consider the patients right to privacy and confidentiality. As with most areas and issues in modern healthcare the statues can be

(TCO D) A patient's family may be actively involved in end-of-life decisions for patients who are incapacitated or incompetent. Compare and contrast two legal cases that address the rights

This scenario presents various ethical issues that could be argued several ways from HIPPA violations to whether or not this patient has/had the cognitive ability to understand the execution of an advanced directive and Power of Attorney. Advance Directives are put in place for this very reason. It eliminates the need for family members to make a choice in the heat of the moment and also respects the wishes of the person whom it affects directly. Although Mr. E’s hypoxia could affect his ability to think clearly one cannot assume that he has an altered level of consciousness nor the inability to execute an advance

The ethical principles for nurses to practice with beneficence and no maleficence. This legal battle between Terri Schiavo’s husband and her family was an ethical debate between continuing artificial life or remove her feeding tube by the request of her husband. Using the theories of utilitarianism and deontology can be applied or considered in making the most ethically correct resolution. The cases are very complex and raise many moral and ethical issues. The cases have brought awareness to society of “the importance of discussing end-of-life issues with family members and underscores how an advance directive, a living will and/or durable power of attorney for health care, are a healthcare proxy clarifies and provides evidence of the wishes of an individual regarding end-of-life decisions. Terri Schiavo should impress upon laypersons and professionals alike the uncertainty of the context in which issues of continuation and termination are argued ethically. Nobody knows what Mrs. Schiavo would have wanted. She left no advance directive and in its absence her husband says one thing and her parents

Although I have to respect the wife’s decision, I choose to be the advocate for my resident because watching him die gasping for air and in pain denies him of his right to dignity and comfort. In order to provide a culturally acceptable care, I have to assess the situation, the background of the involved party, and make a plan of action whether or not nursing advocacy is needed.

There are many ethical issues involved in the scenario provided. De Segonzac (2016) presented a scenario where a DNR patient is being resuscitated against her wishes. In the scenario, Dr. Natalie Manning is attempting to stop Dr. Will Halstead from going against a patient’s DNR order. He continues to ask the husband if he “wants her to live”, while the daughter is asking her father to help her mother. Dr. Halstead blatantly goes against the patient’s known wishes by performing CPR on her.

NBH’s present ethics committee is made up of a multi-disciplinary team who assist us primarily with end-of-life conflicts and policy, education on clinical ethical issues, assisting in formulating policy surrounding clinical ethical issues, brain death and decisions on complicated cases and subsequent policy changes (Annas, & Grodin, 2016). Our ethics committee can also be called upon for organ transplant conflicts, disagreements between patients, families and clinical teams, especially when the dispute can become harmful to the patient (Annas, & Grodin, 2016).

According to Section 5-805 €, “If more than one members of a class assumes authority to act as a surrogate and they, or members of a different class who are reasonably available, do not agree on a health care decision and health care provider is so informed, the supervising health care provider may comply with the decision of the class having priority or a majority of the members of that class who have communicated their views to the provider.” This means that the health care provider can refer the member of the class to a neutral third party for assistance is resolving the dispute or to a court competent jurisdiction. If the class is evenly divided then the people of lower priority are disqualified. The court or a third party would make the decision for the surgery if all family members’ choices were weighed (State of Mane Article 18

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.

As an administrator I would need to take into consideration the patient’s autonomy, autonomy is recognizing an individual’s right to make his/her own decisions about what is best for them regarding their health care (Pozgar, 2012). The patient’s rights always should be considered before any decisions are made by any other family members. In this scenario it is clear that the patient is unable to make any decisions, the patient has suffered a serious brain damage, and although it is not complete brain death, we must determine how to proceed.

The case of Karen Ann Quinlan led to four basic approaches to this ethical problem; advance directives or other clear evidence of the patients wishes while competent, surrogate decision making (power of attorney), and action in the patients best interest. Each solution has deficiencies both in theory and practice, but there can be no debate that their application has changed the landscape of medical ethics.

Even if the patient's husband remains as her legal surrogate decision-maker, his decisions on the patient's behalf are constrained by legally imposed standards. First, a surrogate is legally required to provide "substituted judgment" on behalf of the patient. This means that the surrogate must act in accordance with the patient's wishes. If substituted judgment isn't possible (i.e., unknown what the patient would want under the current medical circumstances), then the law requires the surrogate to act in the patient's "best interests." Since the medical team has significant input about what would medically be in the patient's interest, a decision by a surrogate which doesn't adhere to this standard should not be automatically followed and may need to be reviewed by the institutional ethics committee, risk management, or legal counsel.