Ethical and Professional Implications

Ethical and Professional Implications

The autonomy of a competent patient is an issue not often debated in medical ethics. Refusal of unwanted treatment is a basic right, likened to the common law of battery, available to all people capable of a competent choice. These fundamental rules of medical ethics entered a completely new forum as medical technology developed highly effective life-sustaining care during the 20th century. Several watershed cases elucidated these emerging issues in the 1960’s and 70’s, none more effectively than that of Karen Ann Quinlan. Fundamentally, this case established that a once-competent patient without the possibility of recovery could have their autonomy exercised by a surrogate in regard to the refusal of life-sustaining treatment. This decision had a profound effect on medical ethics, including treatment of incompetent patients in end-of-life situations, creation of advance directives, physician-assisted suicide (PAS) and active euthanasia.

By ruling in the favor of Mr. Quinlan, the New Jersey Supreme Court allowed for patient autonomy to be exercised by an incompetent patient. Though the legal implications of this decision vary from state to state, medical ethics now had to incorporate the possible refusal of a once competent patient unable to give that refusal. This concept is not one that was totally unexpected by the medical community. By developing machinery capable of sustaining life even in the case of severe deficit, it is only natural that medical ethics would need to adapt, growing to accommodate this new realm of consideration. Just as a competent person has the right to decide “how much to struggle, how much to suffer, how much bodily invasion to tolerate, and...

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...ctly protected right, but patients and physicians must be much more willing to discuss difficult issues because of the opportunity for cases like Quinlan to arise.

Works Cited

Cantor, Norman L.. "Twenty-Five Years After Quinlan: A Review of the Jurisprudence of Death and Dying." Journal of Law, Medicine and Ethics 29 (2001): 1073-1105.

Garrett, Thomas, Baillie, Harold, and Garrett, Rosellen. Health Care Ethics; Principles and Problems. 4th Ed. Upper Saddle River, New Jersey. Prentice Hall,

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Meisel, Alan. "Quality of Life and End-of-Life Decision Making." Quality of Life Research 12 (2003): 91-94.

Supreme Court of New Jersey. The Matter of Quinlan. Washington: GPO, 1976.

Sulmasy, Daniel. "The Accuracy of Sustituted Judgements in Patients with Terminal Diagnoses." Annals of Internal Medicine 128 (1998): 621-629.