...The Feeding Tube 1. Explain how the Patient Bill of Rights applies to this situation. The patients of the country in the United States are provided a particular right. This right is called the Patient Bill of Rights (Kronenfeld, 2002). The Patient Bill of Rights has a significant impact and is essential for the people who are in the health care organization for the purpose of getting treatment properly and easily. In this scenario, June is suffering from anorexia and the doctors feel she may need to be placed on a feeding tube to save her life. June agreed to the procedure but became combative, disoriented and refused to have the tube place the evening before the procedure was to take place. The patient bill of rights applies, as the patient has a right to know what treatment options are available to one and what the possible outcomes may be. The patient has a right to decide one’s medical care. One also has a right to know of any side effects of treatments. June needs to be told what may happen without the feeding tube and what can be expected with the feeding tube. June also has a right to have her health information kept confidential, with information given only to those she designates as being allowed to have her health information (Showalter, 2008). It is noted that in the absence of a progressive terminal disease, the feeding tube may be used to prolong life and since the patient is not dying of another cause, discontinuing the feeding tube would imply a desire to cause...
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...Mortality, February 2005; 10(1): 69 – 81 Tube feeding: Prolonging life or death in vulnerable populations? ELAINE J. AMELLA, JAMES F. LAWRENCE, & SUZANNE O. GRESLE Medical University of South Carolina, Charleston, SC, USA Abstract Tube feeding can be an appropriate and effective means of providing nutrition for individuals who are unable to achieve adequate nourishment orally because of various medical problems. However, the delivery of nutrients by tube feeding can cause ethical 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...
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...Running head: LEGAL CASE STUDY: TERRI SCHIAVO CASE Legal Case Study: The Terri Shiavo Case University of Phoenix Legal Case Study: Terri Schiavo Case Terri Schiavo sustained a permanent brain injury on February 25, 1990. She did not have a living will or a durable power of attorney. Her husband, Michael Shiavo, was appointed her legal guardian. Because Ms. Shiavo was unable to swallow, a feeding tube kept her alive and nourished. Later that year, she was determined to be in a persistent vegetative state (PVS). Throughout the early 1990’s, Mr. Shiavo worked hard with his wife’s health care team, providing her with extensive rehabilitation, which included physical, occupational, and speech therapies. Despite this effort, Ms. Shiavo’s condition did not improve. After he accepted his wife’s prognosis, he worked to follow through with what he stated were her beliefs that she would not want to continue to be kept alive through the means of artificial life support. Her parents disagreed with his convictions of what his wife would want, and subsequently the most watched ethical dilemma played out for the world to see. (Perry, Churchill, & Kirshner, 2005). This case has been the focus of medical, legal, theological, ethical, political, and social controversy nationwide. The case alone threatened to undo thirty years of ethical and legal progress enabling individuals to control and limit medical interventions performed on them. (Hook & Mueller, 2005). This paper will discuss...
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...Theory in Practice This is a case of a 34-year old woman called June who is suffering from severe anorexia. She agrees to be placed on a feeding tube in order to save her life. On the evening before the tube is placed, June becomes disoriented and physical and totally refuses to have the feeding tube placed. The ethical dilemma sets in when the parents insist that the tube must be inserted despite her refusal, while the ex-husband wishes to uphold June’s final decision which most certainly will lead to her demise. The hospital administrators seek legal counsel in order to save the situation. This case though a sad one, presents with it several repercussions. This paper will explain the various implications that June’s case presents in the contemporary world and the various paths used to derive the elusive “right” decisions on the way forward. The patients’ bill of rights is a document that was developed by the American Hospital Association in order to improve the relationship between the patient, the medical staff and employees in the provision of health care. It enumerates several rights that a patient is entitled to before, during and after getting treatment. While this document is not law; it is very important in ensuring that all activities towards a patient’s health are carried out with consideration for their values and dignity (Maryland Hospital, 2011). The patient’s bill of right gives June several privileges as a patient concerning her treatment. First, she...
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...AHRQ Health Law and Regulations Shelia Y. Janice HCS/545 Donna Lupinacci RN, MSN January 22, 2013 AHRQ-Health Law and Regulations Today we will have the pleasure of learning about the Agency for Healthcare Research and Quality. This government agency is tasked with improving safety, quality, effectiveness and efficiency in the health care system. We will examine the role of this governmental regulatory agency and the impact it has on the health care industry, current laws and regulations being faced by the AHRQ and the impact these laws and regulations have on providers and hospitals. Once we are done learning, we will all be able to relate situations we see or have seen in our own lives and communities. AHRQ Snapshot Dedicated to improving quality, safety, efficiency, and effectiveness of health care, AHRQ continues to build the knowledge base for what works and what doesn’t work in health care by working with public and private sectors and translates the information into everyday practice and policymaking. (AHRQ, 2013). The impact of AHRQ’s research is essential and very beneficial as people are able to understand the many ways to improve service delivery in the health care arena as well as addressing any other areas of need. Some major areas that have been under research such as information technology, health care utilization and costs, medication safety, disaster preparedness, illness prevention and other special needs in specific...
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...decisions about end-of-life care ahead of time. They provide ways for you to communicate you’re wishes to family, friends, and healthcare professionals to avoid confusion later on. Advance directives centers around the principle of your right to die and death with dignity. With an advance directive, you can express how much or how little you want done for you when you are no longer able to make decisions. (Advance Directives) Legal documents can ease end-of-life decisions. Congress passed the Patient Self Determination Act (PSDA), which became effective in 1991. The act requires all health-care institutions that receive Medicare or Medicaid funds to provide patients with written information about their right under state law to execute advance directives, but it does not require states to adopt or change any substantive laws. The written information must clearly state the institution’s policies on withholding or withdrawing life-sustaining treatment. The PDSA also requires facilities to document in each patient’s medical record whether an advance directive has been executed, to educate staff and the public about the right to forgo treatment, and to ensure institutional compliance with state law. Violation of the act can lead to loss of federal funding. (Markus) One type of directive that patients in many states can execute designates an agent to make healthcare decisions for them if they become mentally incapacitated. The process involves drafting a durable power of attorney, which...
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...Business Ethics in a Hospital Setting Darlene V Nickerson Columbia Southern University Abstract Business ethics in a hospital setting includes a review of many areas. Ethical considerations include the areas of patient care, nursing ethics, physician ethics, patient privacy, and medical billing practices. This paper will touch on ethical concerns for each of these topics. Keywords: hospitals, ethics, patient care, nursing, physicians Business Ethics in a Hospital Setting When beginning a discussion of business ethics in a hospital setting it is important to take a broad approach. Because a hospital is a business and also a treatment facility, the ethical concerns must be considered not only for areas such as billing and privacy but also for ethics related to the appropriate care of patients, nursing ethics, and physician ethics. The ethics of the treatment methods employed based on the patient’s condition must also be considered. Ethics and Patient Care I believe that when discussing the ethical implications of patient care it is helpful to review a real-world scenario. One highly publicized case involved Terri Schiavo and her husband’s fight to stop her tube feedings as there was no hope for her recovery (VandeKieft, 2005). One reason for the high visibility of this case in the media occurred because the patient's husband and the patient's family disagreed on the diagnosis (VandeKieft, 2005). Terri suffered a cardiac arrest due to severe hypokalemia (low potassium...
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...Death with Dignity If we assume that every human being born into this world has a "right to life," then it logically follows that every human being has a right to end their life (or a "right to die"). Because death is a part of life, a person's right to life logically assumes a right to not have that life. Thus, any law upholding a person's right to life has inherent within that same law a person's right to die, otherwise it would not be a right to life in the true sense of the term. But there is a legal battle going on in America right now over whether or not a person has a right to die. Does the government have the right to prolong your life by artificial means whether you desire it or not? With the passing of this law nationwide, you, as the voter will simply be saying, “It is YOUR choice” (Patashnik, 2004) The issue of “Having a Personal Right to Die,” has been long simmered beneath the surface in legal and political circles: under what circumstances do terminally injured and ill Americans have the right to choose to die? The Supreme Court made a definitive statement in the landmark 1990 case Cruzan v. Director, Missouri Dept. of Health that severely injured patients have a constitutional right to refuse medical treatment and die. But the court also ruled that states can require "clear and convincing" evidence of a patient's intent to forgo medical treatment, a rather high evidentiary standard to meet. History The actual word for “having a right to die” is Euthanasia...
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...FINAL EXAM REVIEW Know which residents make up the majority of Long-term Care facility admissions [page 1] Difference between a policy and a procedure [page 5] Policy is a course of action that should be taken every time a certain situation occurs. (Example, a very basic policy is that healthcare information must remain confidential.) Procedure is a method or way of doing something. (Example, your facility will have a procedure for reporting information about residents. The procedure explains what form to complete, when and how often to fill it out, and to whom it is given.) Scope of practice for nursing assistants, specific tasks outside of the scope of practice [page 15] The things you are allowed to do and how to do them correctly. Tasks outside the scope of practice: NAs do not administer medications unless trained and signed to do so, NAs do not honor a request to do something outside the scope of practice, not listed in the care plan, or not on the assignment sheet, NAs do not usually perform procedures that require sterile technique. NAs do not diagnose or prescribe treatments or medication, NAs do not tell the resident or the family the diagnosis or the medical treatment plan. Describe the purpose of the care plan [page 16] A care plan is created for each resident by the nurse or doctor. The care plan is a guide to help the resident reach and maintain the best level of health possible. Long-term care survey process [page1] Surveyors study how well staff care...
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...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 Public Policy: An Argument Against...
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...on May 5, 2011. The article is titled “Montana Dad Gives Cancer-Stricken Boy Marijuana Behind Doctor’s Back” (James, 2011). A two year old child named Cash was diagnosed with a stage four brain tumor. He lived in Montana and was taken to Salt Lake City, Utah for extensive chemo therapy treatment. He suffered septic shock, a stroke, and a pulmonary hemorrhage. The child was extremely sick and went 40 days without eating. Due to the nature of his illness his body was shutting down and the family was frightened. Doctors were doing everything possible for this child. The father who had extensive knowledge on the use of medical marijuana (had used it himself for Attention Deficit Disorder) decided to give it to his son through his feeding tube without the doctors knowledge. The marijuana was legal in Montana but not in Utah (“15 legal,” 2011). Each day the father gave his son 3mm of the marijuana liquid twice daily. He feared...
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...Advance Directives—research and discuss the legal and ethical basis for Advance Directives such as the Living Will and Durable Power of Attorney for Healthcare. Why are these documents so valuable in healthcare situations? What legal authority do these documents provide for decision making by family and/or healthcare providers? Briefly discuss a situation in which a Living Will might apply and would be of benefit to those involved. Once you have researched and discussed Advance Directives, draft a sample Living Will, indicating the type of content that should be found in such a document. Some students take this opportunity to prepare their own actual Living Will, and that certainly is encouraged. What Are Advance Directives? Advance directives are a written statement, made in advance by a legally competent adult, that appoint someone to make healthcare decisions if a person becomes incapable of making decisions and unable to communicate his or her wishes. Advance directives also provide instructions which define the type of treatment or care a person would want or not want under particular conditions. Doctors, other members of the healthcare team, family members and/or appointed “agents” use these documents to ensure that a person’s preferences are honored in a critical healthcare situation (National Hospice and Palliative Care Organization, 2008). Legal and Ethical Principles Legal Basis It is an accepted legal theory that a legitimately competent person is empowered to...
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...EUTHANASIA: The intentional killing by act or omission of a dependent human being for his alleged benefit. (If death is not intended, it is not an act of euthanasia) ARGUMENTS FOR EUTHANASIA: It provides away to relieve extreme pain It provides a way of relief when a person’s quality of life is low Frees up medical funds to help people It is another case of freedom of choice ARGUMENTS AGAINST EUTHANASIA: Euthanasia devalues human life Euthanasia can become a means of health care cost containment Physicians and other medical care people should not be involved in directly causing death There is a “slippery slope” effect that has occurred where euthanasia has been first been legalized for only the terminally and later laws are changed to allow it for other people or to be done non-voluntarily. Opposition overcomes 48 point deficit to defeat assisted suicide - Ballot Question 2 in Massachusetts 1 1 0 Google BOSTON, Nov. 7, 2012 /PRNewswire/ -- In a stunning upset, the voters of Massachusetts soundly defeated Ballot Question 2 on Election Day. Dealing a significant setback to the expansion of the assisted suicide movement throughout the United States by Compassion & Choices (the organization formerly known as the Hemlock Society), a diverse coalition of disability rights organizations, medical associations, nurses' groups, community leaders and faith-based organizations united in this effort. "Tonight was a huge victory for those of us in the...
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...Week Two Wrap Up – The Fabric of Healthcare Law By Mary Nell Cummings In week two we discussed how legislation and other laws affect healthcare delivery. While there is no need to understand any law in detail at this point in the course, it is important to understand the source of law. Also, it is important to understand how law affects your organization, as well as how your organization complies with legal requirements. Finally, your understanding of the sources of law, and the process of regulation will help you to make good decisions as a health care administrator. The Sources of Law Many people believe that all law comes from the Congress or from state legislatures. They believe that law is synonymous with “statute” which is a particular kind of law – drafted, debated, and voted on by a group of legislators. This is of course, not correct. There are many other sources of law. There is the federal constitution, and the constitution of each state. There is law made through regulatory agencies (administrative law) and there is law made by judicial decision (common law). This combination of approaches and interests leads to the rich fabric that is simply described as healthcare law. Common Law Contract Law: Contract law is at the heart of healthcare delivery. Insurance companies enter into contracts with patients, providers, facilities, and governments (state and federal). Doctors and hospitals enter into contracts with one another. Unions and employers enter into contracts with...
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...Running Head: INTENT AND IMPACT OF PUBLICITY-ORIENTED LEGAL CHALLENGES TO PHYSICIAN-ASSISTED SUICIDE. Intent and Impact of Publicity-Oriented Legal Challenges to Physician-Assisted Suicide Elena Mikhaylov Student Keller Graduate School of Management – Online HS542 Keri Bahar February 2012 Introduction The word Euthanasia originated from the Greek language: eu means “good” and thanatos means “death”. In Ancient Greece it meant literally "the good death". The term euthanasia normally means that the person who wishes to commit suicide must initiate the act. The Oxford English Dictionary Online (2nd edition, 1989; online version Sep. 2011) provides the following definitions of euthanasia: "A gentle and easy death...[T]he means of bringing about a gentle and easy death... However, in today’s society term euthanasia includes both voluntary and involuntary termination of life. Euthanasia has many meanings. Except for involuntary euthanasia, all these terms are closely related because the victim requests the action. The only difference is who is actually committing the act, Voluntary euthanasia is a help to mentally competent person to die through the assistance of others and can be divided in two categories. Passive Euthanasia means causing the death of a person by withdrawing some form of support and letting nature take its course. For example: removing life support, stopping medical procedures, stopping food and water and allowing the...
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