Dr. Grey is a physician who works in the Intensive Care Unit ("ICU") of the hospital which employs you in an administrative capacity.You receive a report regarding Dr. Grey's activities relating to the care of three ICU patients:

1. Patient 1 - The first patient is in a persistent vegetative state. She is on a ventilator and administered artificial nutrition and hydration (i.e., she is on a feeding tube).The patient has an executed advanced directive naming her mother as her surrogate decision-maker.The mother indicates that her daughter would not want to live like this, and she requests that the feeding tube be removed but agrees to the continuation of the ventilator to preserve any useful organs.Grey withdraws the feeding tube and the patient dies after several days.
2. Patient 2 - Dr. Grey has a patient who is in great pain and suffering from severe burns received in a house fire. The patient is on a ventilator because he cannot breath on his own. He is able to press the keys on a keyboard to communicate.He makes it clear that he wants the ventilator removed so that he might be permitted to die.He also tells her not to put it back no matter what he says.Grey removes the vent.The patient cannot breath and begins to panic . . . he types, "PUT IT BACK! PUT IT BACK! PUT IT BACK!"Dr. Grey does not do so and the patient dies.
3. Patient 3 - Dr. Grey has a third patient who has "locked-in" syndrome. The only thing he can move is his eyes.He has been diagnosed as terminal and gone through the procedure for Physician Assisted Suicide.This occurs in the state of California.The patient was given a prescription for a lethal dose of sleeping pills which he had filled.However, due to his condition he is unable to take them himself.Grey assists him by dissolving the contents of the pills in a liquid and injecting it into the patient's IV.He dies.

Discuss each case and the end of life issue associated with it. (e.g. euthanasia, assisted suicide)