This problem first began to surface in the 1980s when the court had to face Cruzan v. Director, Missouri Department of Health. In this case the court had to decide by “clear and convincing evidence” that the comatose patient’s (Nancy Beth Cruzan) desire to terminate her life before the courts would allow her family’s wish of disconnecting her feeding tube be carried out. Unfortunately eight of nine judges said no to the proposition and concluded that the right
A physician must understand that when it comes to deciding to withhold or withdraw life sustaining treatment it is ultimately the patient’s decision unless the patient is not competent enough to make this choice. I believe that a person can lose their life at any point. Death is certain and no one can run from it. In my opinion, a patient’s autonomy is of utmost importance anytime during healthcare however the physician can name some recommendations of what would be the best option for the patient. When it comes to patients they deserve to be treated with respect and ultimately be treated as an end not as a means to an end.
The story of Nancy Cruzan is a story that may be extremely controversial regarding what is right versus what is wrong, although this woman has changed both the world of medicine and legality since her death in 1990. Cruzan experienced a tragic car accident and was declared to be in a persistent vegetative state by physicians. The controversial part of the story is in regards to whether she should have a tube feeding continued or if it should be discontinued. The purpose of this paper is to further explore Cruzan’s background story, how protestors affected her case, ethical principles, how healthcare has been affected, the meaning of her gravestone, and the impact on her family.
Though ethics committees have been helpful, scores of physician-patient disagreements end up in the U.S. court system with inconsistent results. The states adopted individual “statutes regulating DNR orders and their provisions vary in analysis throughout the U.S.” (Bishop, Brothers, Perry & Ahmad, 2010). One ethical dilemma that is constant in emergency rooms, the intensive care unit and terminally ill persons is a futility of treatment. In the case of CPR/DNR, New York State wanted to enact a law that describes the decisive responsibilities of the patient, and the family or surrogate, and physician. “In April 2003, the New-York Attorney General asserted that the DNR law would require a physician to obtain a consent of the patient’s health care surrogate before entering a DNR order, even when the physician
When a patient is unable to make decisions for himself or herself, their caregivers and those who know them are appointed to make the decisions based on what the patient would have wanted. This is called surrogate decision making. According to the article Terri Schiavo and End-of-Life Decisions “when surrogate decision makers and caregivers cannot agree upon what that choice would have been, they may turn to the courts to determine either what the now-incapacitated patient would have chosen or who is best suited to choose as the patient would have” (Mathes, 2005)
The appellant of the Cruzan v. Missouri case was the parents of Nancy Cruzan, Joe Cruzan and Joyce Cruzan. The Cruzans argued that when they made the decision to hook Nancy up to a feeding and hydration tube they were unaware that Nancy would be in the vegetative state permanently, they thought she would make it (Cruzan by Cruzan v. Director, Missouri Department of Health. (n.d.). Oyez. Retrieved December 8, 2015, from https://www.oyez.org/cases/1989/88-1503).
After 3 years of hoping Nancy would get better the Cruzan family decided that taking Nancy of the feeding and hydration tube is what Nancy would have wanted and what they thought was best. However the Cruzan's request was refused by the Missouri Department of Health. They believed they needed clear and convincing evidence that taking their daughter of the feeding and hydration tube is what Nancy would have really wanted. The Cruzans disagreed they thought that as her legal guardians they would speak for the decision she can not physically make. The Cruzans then took this to local court, but the case did not stop their. It made its way to the Supreme Court and became known as Cruzan v. Missouri Department of Health. Final outcome of the case was 5-4 in favor of the Missouri Department of Health. "The Court felt that the Cruzan case was best explored in the area of 'liberty' rather than 'privacy.' The Supreme Court upheld the authority of States to demand “clear and convincing” evidence of the injured person's wishes."(Cruzan by Cruzan v. Director, Missouri Department of Health. (n.d.). Oyez. Retrieved December 8, 2015, from
This essay will discuss issues that nurses have to consider when caring for a person that either lacks or have compromised capacity. At the same time, the author will explain important terminology in the essay such as the meaning of consent, capacity, best interest, Deprivation of liberty, advanced decisions, risk assessment, including several examples from experience during placement
The Superior Court of Los Angeles County became a pivotal case in a patient’s right to refuse treatment. In the initial case Ms. Bouvia and her legal team sought a court order to have the NGT removed and to stop all medical treatments she did not consent to. She argued that this treatment would not be a cure for her condition and would not improve her quality of life. The hospital staff argued the interest of the state prevailed over a patient’s right to refuse treatment. They noted that the state and healthcare teams viable interests include: “(1) preserving life, (2) preventing suicide, (3) protecting innocent third parties, and (4) maintaining the ethical standards of the medical profession, including supporting the right of physicians to effectively render necessary and appropriate medical services” (Liang & Lin, 2005). Additionally they sighted Ms. Bouvia’s failed previous attempt to “starve herself to death” in 1983 with the assistance of her medical team. The court denied her request citing these key interests and the fact that medical professionals felt that Ms. Bouvia could live 15-20 additional years with supplemental nutrition justified the state’s interest in preserving her life. The court also stated that any other decision would be condoning a medical team to aid and abet suicide.
Every seriously ill patient and their family should have decided the following issues: proxy, resuscitation, hospitalization, and specific treatments. Every seriously ill person needs to have pointed out a person to speak on their behalf when they get too sick to do so. A “proxy” can be filled out at any hospital or nursing home granting “power of attorney” to a loved one to be able to make decisions. A person
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
The Death with Dignity Act of Oregon, Washington, and Montana has harsh patient eligibility criteria that limit access to competent, legal residents of over age 18, with terminal illness that were given an estimated life expectancy of 6 months or less which is to be confirmed by two independent physicians. There is also a requirement for two oral requests with a 15-day waiting period in between, as well as a written request that must be witnessed. The prescriptions may be written by the physician not less than 48 hours after the receipt of the written request. Patients must be mentally and physically be able to
A more recent case involving patient decision making when they are no longer able occurred in 2015 with Bobbi Kristina Brown. Bobbi died after spending half a year in a coma due to labor pneumonia. The main similarity between Bobbi’s and Terry’s case was the age of the patients. They were both adults which ended up in a vegetative state and unable to take the decisions for themselves. However, unlike in Terry’s case, Bobbi’s relatives were appointed to handle the decisions regarding her treatment. They gave a chance for Bobbi to recover before making the decision to remove the artificial feeding.
Sister Juana De la Cruz uses the Reply to Sr. Filotea as a way to address the issue of equal education for women. She begins her argument by stating that as a nun she should focus more on the study and explication of the scriptures, and that without proper education one could not achieve this goal. She goes on to say that she is not well-versed enough to address these topics and because of this she should start to study things such as math and science in order to grow closer to God. Sister Juana also uses religion to argue that her ambition for learning is not a sin. In the Catholic church, one cannot sin until they reach the age of seven. Knowing this Sister Juana says that her hunger for learning has been with her since the age of 3;