In A Sentence Or Two, Identify The Main Issue And Outline Th

In A Sentence Or Two Identify The Main Issueoutline The Facts

Mary Evelyn Greene, who has memory impairment, resides in a private room at Shady Brook Skilled Nursing Facility. She is 89 years old with health issues related to aging and has experienced significant weight loss recently. Her husband, a successful land developer, left her a substantial estate, which meets her financial needs. Mrs. Greene has expressed a desire to die, and her son David has demanded that the facility honor her wish to withhold life-sustaining treatment, threatening legal action if not comply.

The main issue involves the ethical and legal dilemma of respecting Mrs. Greene’s right to refuse life-sustaining treatment versus the facility’s obligation to preserve life, especially given her cognitive impairment. The case raises questions about her true capacity to make this decision and whether her expressed wishes should be honored in the context of her health condition and potential legal repercussions.

Paper For Above instruction

The presented case underscores complex ethical and legal considerations in healthcare decision-making, particularly concerning end-of-life choices for cognitively impaired patients. Mrs. Greene’s advanced age, health deterioration, and recent weight loss are indicative of her declining health, which necessitates careful reevaluation of her care plan. The primary conflict arises from her son’s assertion that she wishes to die and his demand for the healthcare facility to honor her wish to withhold life-sustaining interventions, threatening legal action otherwise. This situation exemplifies the tension between respecting patient autonomy and the legal and ethical duties of healthcare providers to preserve life.

The right of a patient to refuse treatment, including life-sustaining procedures, is fundamentally rooted in the principles of autonomy and self-determination, enshrined in legal statutes and ethical guidelines (Beauchamp & Childress, 2019). However, when a patient has cognitive impairments, such as memory loss or dementia, determining whether they possess the capacity to make such a decision becomes complex. In Mrs. Greene’s case, her memory impairment calls into question her decisional capacity, a factor that healthcare providers must evaluate through detailed assessments involving medical, psychological, and ethical considerations (American Medical Association [AMA], 2020).

Failure to respect a competent patient’s wishes to decline treatment can lead to serious legal repercussions, including lawsuits for battery, negligence, or violation of patient rights (Tobin & Koumpis, 2021). Conversely, acting against a patient’s expressed wishes without proper assessment could also result in legal liability for neglect or assault, especially if the patient is deemed capable of making informed decisions (Pearson, 2019). Ethical considerations emphasize honoring true patient autonomy, but this is balanced against the obligation to do no harm and to ensure decisions are made with full capacity (Gawande, 2020).

As a member of the ethics committee, my first step would be to ensure a comprehensive capacity assessment is conducted by qualified healthcare professionals, including neurologists and psychologists. This evaluation would clarify whether Mrs. Greene understands the nature and consequences of her decisions, thus providing a factual basis for the ethical deliberation (Jonsen, 2019). The committee should also review her advance directives, if any, and consider her previously expressed wishes versus her current mental state. Clarity on these points is essential to uphold the principles of beneficence, non-maleficence, autonomy, and justice in resolving this dilemma (Beauchamp & Childress, 2019).

The facility should also facilitate a family meeting involving Mrs. Greene, her healthcare team, and her next of kin to discuss her wishes, health status, and prognosis transparently. This collaborative approach helps in aligning medical recommendations with ethical standards and legal requirements (Simmons & Miller, 2022). Additionally, creating a detailed, documented care plan that respects Mrs. Greene’s best interests and legal rights minimizes the risk of future disputes and legal actions. Implementing palliative care options might provide her with comfort, dignity, and quality of life, aligning with holistic patient-centered care (Sullivan & Williams, 2021).

Real-world scenarios reflect that honoring a patient’s right to refuse treatment, especially in cases of advanced dementia or cognitive decline, often involves complex legal proceedings and ethical debates. Landmark cases such as Terri Schiavo’s lawsuit illustrate the importance of thorough capacity assessments and respecting prior legal directives (Rosenbaum, 2020). Healthcare institutions must adhere to state laws regarding living wills, durable powers of attorney, and substitute decision-makers to navigate these dilemmas effectively (Kapp, 2019). Proactive documentation and early advance care planning are crucial to ensuring patient wishes are honored without unnecessary legal conflicts (Fried, 2018).

In conclusion, the case of Mrs. Greene exemplifies the delicate balance between respecting patient autonomy and ensuring ethically appropriate care. The healthcare team and ethics committee must meticulously evaluate her decisional capacity, review legal documentation, and involve her family to reach a resolution consistent with legal standards and ethical principles. By implementing thorough assessments, transparent communication, and compassionate care strategies, healthcare providers can address the moral and legal complexities of end-of-life decision-making with integrity and respect for the patient’s dignity.

References

• Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics (8th ed.). Oxford University Press.
• Fried, T. R. (2018). Challenges in completing advance care planning. Journal of the American Geriatrics Society, 66(4), 711-713.
• Gawande, A. (2020). Being Mortal: Medicine and What Matters in the End. The New York Times Company.
• Jonsen, A. R. (2019). Clinical ethics: A practical approach to ethical decisions in clinical medicine. McGraw-Hill Education.
• Kapp, M. B. (2019). The legal aspects of advance directives and surrogate decision making. Health Law Journal, 32(2), 75-85.
• American Medical Association. (2020). Evaluation of Capacity to Make Medical Decisions. AMA Journal of Ethics, 22(3), E206-210.
• Pearson, R. (2019). Ethical dilemmas and legal challenges in end-of-life care. Journal of Healthcare Law & Policy, 22(2), 341-356.
• Rosenbaum, S. (2020). The Terri Schiavo case and implications for health law. Harvard Law Review, 134(3), 747-777.
• Simmons, S., & Miller, L. (2022). Facilitating family discussions in end-of-life care. Journal of Palliative Medicine, 25(8), 1024-1030.
• Sullivan, M., & Williams, B. (2021). Palliative care: Principles and practice. Oxford University Press.