...Ethically, the medical staff enforced their code of ethics by doing what was necessary for the patients’ health. The medical professionals in this case did what they thought was the right thing to do by inserting a feeding tube to make sure that Bouvia was receiving the proper nutrition. In healthcare there are several professional standards in which they need to abide by in order to deliver the highest level of quality of care that is necessary for the better health of the patient. For instance, healthcare professionals are to “only perform procedures [they] have been trained and are legally able to do; use only approved, correct procedures; obtain proper authorization before performing any procedure; and identify patent and receive their consent before performing procedure” (personal communication, November 12, 2015). According to the case, .the medical professionals did not adhere to the proper standards when performing the procedure on Elizabeth Bouvia. Legal obligations coincide with ethical obligations, but are quite different. By definition, legal obligations are “dut[ies] that [are] enforced by a court of law” Legally, they were unable to perform the procedure due to the fact that Bouvia did not consent to the procedure. After researching the legal obligations of a healthcare professional, there are several laws in which medical staff need to abide by legally. The 42 U.S. Code § 1320c–5 states that a practitioner will provide quality in which “meets professionally...
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...Ethics Case Study: Dax’s Case Cindy Siegel Did Dax have an ethical right to refuse care? A legal right? Why/why not? Using the Ethical Analysis Paradigm from class slides; there are four principles that need to be addressed in order to reach an ethical decision. • Medical Indications – diagnosis, prognosis, treatment option o Dax had severe burns to 65% of his body, including his face, hands, eyes o Without treatment and allowed to return home, would likely result in death from infection • Patient Preferences – preferences and values, capacity to decide, informed o Repeatedly demanded that treatment be discontinued o Demanded to be discharged to home o Informed of risks and refused treatment o Had capacity to make and communicate decisions • Quality of Life – as experienced by patient o Excruciatingly painful treatments o Amputation of several fingers – minimal use of hands o Blind o Dependent on others • Contextual Factors – family, law, financial o Legal right to refuse treatment At issue is Dax’s ethical right to refuse care. While he may not have made the choice that physicians and/or hospitals would, he has a fundamental right to make choices concerning his treatment and there should be respect for his autonomy in doing so. Physicians, who take an oath to “First do not harm...,” may struggle with their ethical viewpoints, however, this decision is about Dax’s ethical right, not theirs. Since Dax is presumed competent, he does have the ethical right to refuse care,...
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...dilemmas in cases where the effectiveness of tube feeding diminishes and medical complications increase. The decision to tube feed is often influenced by regional and cultural preferences, as well as the high cost of providing mealtime assistance. The effectiveness and appropriateness of tube feeding has been the subject of much debate as it applies to those with severe cognitive impairments and those who are in a persistent vegetative state (PVS). Recent research shows that in these vulnerable populations, tube feeding alone does not necessarily prevent malnutrition and risk of infection or improve functional status and comfort. While advanced directives allow an individual to make decisions about his or her care at the end of life, court cases and religious doctrine examine the individual’s right to autonomous decision making in opposition to preserving the sanctity of life. As long as the outcome of this debate is largely undecided, the process of dying may be prolonged for those who can no longer advocate for themselves. Keywords: Enteral feeding, tube feeding, ethics, persistent vegetative state, dementia, palliative care Introduction Nutrients are introduced into the body in two ways: by enteral feeding through the digestive tract, and by parenteral feeding through a tube inserted in a vein in an arm or leg (peripheral line) or through the chest wall in...
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...Cambridge University Press 0521804167 - Euthanasia, Ethics and Public Policy: An Argument Against Legalisation John Keown Frontmatter More information EUTHANASIA, ETHICS AND PUBLIC POLICY An Argument against Legalisation Whether the law should permit voluntary euthanasia or physicianassisted suicide is one of the most vital questions facing all modern societies. Internationally, the main obstacle to legalisation has proved to be the objection that, even if they were morally acceptable in certain hard cases, voluntary euthanasia and physician-assisted suicide could not be effectively controlled; society would slide down a slippery slope to the killing of patients who did not make a free and informed request, or for whom palliative care would have offered an alternative. How cogent is this objection? This book provides the general reader (who need have no expertise in philosophy, law or medicine) with a lucid introduction to this central question in the debate, not least by reviewing the Dutch euthanasia experience. It will interest readers in any country, whether for or against legalisation, who wish to ensure that their opinions are better informed. john keown is Senior Lecturer in the Law and Ethics of Medicine, Faculty of Law, University of Cambridge. His previous publications include Abortion, Doctors and the Law (1988) and Euthanasia Examined (1995). © Cambridge University Press www.cambridge.org Cambridge University Press 0521804167 - Euthanasia, Ethics and...
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