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Medical Law and Ethics
Medical Law and Ethics
Chapter 3 medical legal and ethical issues
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A patient’s spouse or other family members have no right to override the patient’s decisions or their doctor’s understanding of them. Though, the patient’s doctor does have the right to overrule their living will. For example, if a patient’s doctor believes that going along with their wishes in spite of their living will, will harm someone else like an unborn child in a mother’s womb, he can overrule it. Circumstances defined in a person’s living will may not always concur some situations. When this happens, the patient’s medical care team will make a decision based on the “spirit” of the living will to be careful, and will contact anyone named in the patient’s living will along with their primary care doctor or clergy in attempt to spell out the patient’s desires since they are not able to overrule the living will. Clearly, when everyone involved are in agreement with the patient’s requests, the situation is made much easier. Legal and ethical dilemmas are possibly created if everyone involved is not supportive. A patient should review his or her living will every year due to advancements in science and medical treatments that may affect them in the future along with the possibility of their feelings changing, based on many factors and laws that may change over the years. There are three different types of living wills a person can make. One is a statement made by a person diagnosed with a terminal condition before any deterioration and after all medical measures have been exhausted. Another is a statement made by a person of good health and quality of life that is written prior to becoming ill. The third is a statement of issues surrounding a patient’s religious convictions which could include their spouse, stepchildren, adopted...
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...e patient. Financial situations such as these are an example of if a patient would like treatment introverted, then their wishes should be granted and respected.
“Clearly the preservation of life is an important goal of the human community in general and of the profession of medicine in particular. Intuitively we know life is valuable and sacred; for were it not, then nothing else would be” (Shannon, 2011, 633). Living wills give patients control over their own bodies even when they are in a state of unconscious vegetate. It gives them the comfort of knowing that their wishes will be granted when they are not in a coherent state. The patient’s family does not have the right to override their living will. That should be a good reason to create a living will, reducing the weight on the patient’s family, because in the end, only the patient’s living will, will prevail.
Once I explained exactly what a living will is because some were unaware they were very comfortable with the idea of filling out a living will. The responses that I got all varied to different degrees. My brother stated that he did not yet have a living will but that they are very important to have and everyone should get one. He said that his wishes would be to pretty much “pull the plug in every circumstance”. He absolutely did not want to be put on life support, be artificially supplied with food, or get life sustaining drugs, machines, or other medical procedures. My mother had wishes the same as I would have which is to consider the circumstances and give me a month to evaluate if I have the possibility of making a full recovery. If there is no hope of having a full recovery then I want all life sustaining measures to be stopped because I don’t in any way want to be a burden on
Signing for the treatment, procedures, medications. He or she has the right if the patient death the appointee has the right to order where the burial should take place. The family members in this case have zero rights, they are unable to exercises any thing because of the legal stand point of the living will. But if the patient in question has no living will under the different laws the person in command is her or her spouse if there is no spouse. The next in commander is his or her children’s.
As we get older and delve into the real world, it is important to start thinking about end-of-life care and advance directives. Although it is something no one wants to imagine, there is an absolute necessity for living wills and a power of attorney. Learning about the Patient Self-Determination Act and the different legal basis in where you live is important because it will help people understand why advance care directives are so important. Although there are several barriers in implementing advance care directives, there are also several actions that healthcare professionals can take to overcome these obstacles. These are also important to know about, especially for someone going into the medical field.
Social Attitudes Survey noted that 78% of respondents believe that “the law should require doctors to carry out the instructions of a Living Will” (Park et al, 2007). These decisions become important once patients lose their mental capacity, are unconscious, or unable to communicate” (BMA, 2009). The Mental Capacity Act 2005 defines an “advance decision” as a decision made by a person 18 or over, when he or she has the capacity to do so. The implications of a Living Will, make the case against legalising assisted dying weaker. This is because if a person is legally allowed to set out which treatments they will or will not agree to, and can refuse life sustaining treatments by creating a legal document, then why shouldn’t an individual in extreme pain who is able to make the request at the time be able to ask for assistance in
Healthcare providers must make their treatment decisions based on many determining factors, one of which is insurance reimbursement. Providers always consider whether or not the organization will be paid by the patients and/or insurance companies when providing care. Another important factor which affects the healthcare provider’s ability to provide the appropriate care is whether or not the patient has been truthful, if they have had access to health, and are willing to take the necessary steps to maintain their health.
The patients will have the understanding that if they cannot keep fighting the option is available. ¨ There is not more profoundly personal decision, nor one which is closer to the heart of personal liberty, than the choice which a terminally ill person makes to end his or her suffering and hasten an inevitable death¨ ( Sarah Henry, 1996, p. 10). If they are ready to end it, the option is available. They know the choice they make will affect them, but it also helps to know if they cannot go on they can tell the doctor and they will end it. ¨ Unitarian Universalist Association of Congregations is the first religious group to pass in favor of Euthanasia for the terminally ill¨ ( Leading Issue Timelines, 2017, p. 8¨. The terminally ill should have the right to know if they are going to be allowed to end their lives if the fighting gets hard and to unbearable. They do not want to give up just to be on the road of a slow and possibly painful death. ¨ Between physician and patient concerning a request for assisted suicide be witnessed by two adults¨ ( Yale Kamisar, 1998, p. 6). The doctor´s are not going to just inject the patient with the killing drug. The patient has to be able to say for themselves and someone else has to be present when said, when gone over and when they are injected. The family can know their family member really wants to follow through with it and they have
One of the greatest dangers facing chronic and terminally ill patients is the grey area regarding PAS. In the Netherlands, there are strict criteria for the practice of PAS. Despite such stringencies, the Council on Ethical and Judicial Affairs (1992) found 28% of the PAS cases in the Netherlands did not meet the criteria. The evidence suggests some of the patient’s lives may have ended prematurely or involuntarily. This problem can be addressed via advance directives. These directives would be written by competent individuals explaining their decision to be aided in dying when they are no longer capable of making medical decisions. These interpretations are largely defined by ones morals, understanding of ethics, individual attitudes, religious and cultural values.
The medical Profession recognizes that patients have a number of basic rights. These include but are not limited to the following: the right to reasonable response to his or her requests and need and needs for treatment within the hospital's capacity. The right to considerate, respectful care focused on the patient's individual needs. The right of the patient to make health care decisions, including the right to refuse treatment. The right to formulate advance directives. The right to be provided with information regarding treatment that enables the patient to make treatment decisions that reflect his or her wishes. The right to be provided upon admission to a health care facility with information about the health care provider's policies regarding advance directives, patient rights, and patient complaints. The right to participate in ethical decision making that may arise in the course of treatment. The right to be notified of any medical research or educational projects that may affect the patient's care. The right to privacy and confid...
While navigating the abundant and sometimes confusing legal language of advance directives can be time consuming, it would benefit every person to consider their end of life wishes and have some form of written statement available for their doctor and family to understand those wishes. Doing this in advance can prevent emotional anguish, suffering and expensive litigation. In the end, clearly and when possible, written, documentation of a medical directive, a living will, or a chosen health care power of attorney will lessen the burden for the medical professionals and family of a dying or incapacitated person.
Another reason a patient may opt to euthanasia is to die with dignity. The patient, fully aware of the state he or she is in, should be able choose to die in all their senses as opposed to through natural course. A patient with an enlarged brain tumor can choose to die respectively, instead of attempting a risky surgery that could leave the patient in a worse condition then before the operation, possibly brain-dead. Or a patient with early signs of Dementia or Alzheimer’s disease may wish to be granted euthanization before their disease progresses and causes detrimental loss of sentimental memories. Ultimately it should be the patient’s choice to undergo a risky surgery or bite the bullet, and laws prohibiting euthanasia should not limit the patient’s options.
Since the patient is not able to give informed consent it should be noted that George’s spouse should be the one to determine the best course of action. It would be up to his wife, Helen, to decide what should be done about continuing or discontinuing treatment. If she decides to respect George’s wishes, then treatment will cease. But the renal dialysis will resume if she chooses to ignore George’s request. This is only true if George is unable to achieve competency, such as treating his depression and then reevaluating if he still believes he should no longer be treated with renal dialysis to end his
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
As patients come closer to the end of their lives, certain organs stop performing as well as they use to. People are unable to do simple tasks like putting on clothes, going to the restroom without assistance, eat on our own, and sometimes even breathe without the help of a machine. Needing to depend on someone for everything suddenly brings feelings of helplessness much like an infant feels. It is easy to see why some patients with terminal illnesses would seek any type of relief from this hardship, even if that relief is suicide. Euthanasia or assisted suicide is where a physician would give a patient an aid in dying. “Assisted suicide is a controversial medical and ethical issue based on the question of whether, in certain situations, Medical practioners should be allowed to help patients actively determine the time and circumstances of their death” (Lee). “Arguments for and against assisted suicide (sometimes called the “right to die” debate) are complicated by the fact that they come from very many different points of view: medical issues, ethical issues, legal issues, religious issues, and social issues all play a part in shaping people’s opinions on the subject” (Lee). Euthanasia should not be legalized because it is considered murder, it goes against physicians’ Hippocratic Oath, violates the Controlled
The delivery of healthcare mandates a lot of difficult decision making for healthcare providers as well as patients. For patients, much of the responsibility is left to them especially when serious health problems occur. This responsibility deals with what treatments could be accepted, what treatments could be continued, and what treatments could be stopped. Overall, it considers what route should be taken in regards to the health interests of the patient. However, there are circumstances in which patients cannot decide for themselves or communicate what they want in terms of their healthcare. This is where the ethical issue concerning who should be responsible for making these important healthcare decisions occur if a patient was to be in this sort of situation. Healthcare providers can play a role in the healthcare decision making as their duty is to act in the best interest of the patient.
If the patient wants to be treated, then it has to come from them, or all the work would be done in vain because the person does not want to admit that they need help.