Question
Assume that Susan Morris is a 76-year-old woman who has diabetes and very poor eyesight. She has been a widow for many years and has
Assume that Susan Morris is a 76-year-old woman who has diabetes and very poor eyesight. She has been a widow for many years and has one son who lives several hundred miles away. She came to the hospital six days ago because of shortness of breath and was admitted for in-patient care. At the time, she was fully alert and chatty. There was no conversation between Ms. Morris and her physicians about her wishes for end-of-life care, and she does not have an advance directive. Her son was notified of her admission, and he says that he told her physicians that his mother should not be put on a ventilator or given cardiopulmonary resuscitation (CPR). There was no mention in Ms. Morris' hospital chart of his statements.
The day after her admission (a Friday), Ms. Morris experienced respiratory distress. Although she was quickly intubated (i.e., had a breathing tube inserted into her upper respiratory tract) and put on a ventilator, she suffered a severe heart attack in the process. When her son arrived that night, he found Ms. Morris on a ventilator and responsive only to painful stimuli. He says he asked her doctors to discontinue the ventilation, but none responded to his requests.
Three days later (a Monday), the son found the physician in charge of the coronary care unit where Ms. Morris was being treated and demanded that the ventilator be discontinued. The physician asked for an ethics consultation. The son came with his mother's pastor. Both men, on request, gave notarized statements that Ms. Morris had clearly stated that she did not want any "machines" when her time came. Her son volunteered that his mother had visited earlier in the month, and he observed that she was not taking her insulin for her diabetes and that she was eating a lot of sweets. He said he thought that this was her way of trying to end her life.
The lead physician believes that the patient's condition is reversible (i.e., that she can be restored to a condition of being fully alert). He asked for more time to prove it so that Ms. Morris might be able to speak for herself. The family (which includes several nieces and nephews) agreed to wait for two more days until today.
Ms. Morris is much improved today. Her kidney function, which had been failing, is close to normal, and her heart is working much better. She is now responsive to light touches and verbal commands such as "raise your right hand." However, she is not able to sustain a conversation.
The family has not changed its demand to discontinue ventilation despite the patient's change in condition. The physicians feel that Ms. Morris has a reasonable chance at coming back to her pre-admission baseline. They asked for a bit more time to bring back her mental capacity so that she can speak for herself. The family is unwilling to do follow this steps. They are convinced that she would not want machines ever, under any circumstance, even if the machines would be needed only temporarily.
You work in the hospital's legal office, and you have been called by the ethics consultant for advice on how to resolve this case. What would you write? Assume the events described above occurred in the State of Florida.
Be sure to start by reading
http://en.wikipedia.org/wiki/Terri_Schiavo_case#Schiavo_I:_end-of-life_wishes and then
http://law.onecle.com/florida/civil-rights/chapter765.html and particularly
http://law.onecle.com/florida/civil-rights/765.401.html
How can I respond in a 4-page document along with a works cited page of at least 3 additional resources.
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