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Short Answer #3

1.Describe the difference between active and passive euthanasia.

Active euthanasia is the intentional commission of an act. For example, a physician provides a lethal dose of a medication that results in a patient's death. If the patient commits this act, it is considered suicide (Pozgar, 2020). In most states, active euthanasia can result in legal consequences for active euthanasia as it is against the law. Passive euthanasia is the withdrawal of treatment that results in the death of the patient. An example of passive euthanasia is if a patient is on life-support, and life support is removed (Pozgar, 2020). Passive euthanasia is more acceptable than active euthanasia. Pozgar (2020) expands on active and passive euthanasia, describing that both meet circumstances as voluntary or involuntary euthanasia.

2.What was the purpose of the Patient Self-Determination Act?

The purpose of the Patient Self-Determination Act that became effective in 1990 was to give patients the right to choose the type of medical treatment they would be agreeable to receive and the kind of care they would refuse (Pozgar, 2020). The Patient Self-Determination Act acknowledges that patients have the right to establish advance directives (Pozgar, 2020).

3.What are advanced directives?

Advanced directives allow patients to make medical care choices, even if they are incapacitated (Pozgar, 2020).Advance directives allow patients to establish the type of treatment is acceptable, alternative medicine or treatment, and refusal of treatment (Pozgar, 2020). Advance directives include a living will, durable power of attorney, health care power of attorney, do-not-resuscitate order, organ donation card, and verbal instructions (United States Library of Medicine, 2019).

4.Describe how a living will differs from a durable power of attorney for healthcare.

A living will is a legal document that outlines the patient's wishes for treatment if the patient is incapacitated. The living will inform health care professionals on the type of treatment that is acceptable to the patient. It includes life-support treatment, nutrition, and hydration. The information in a living will may consist of the patient's choice to use dialysis and breathing machines, resuscitation, tube feeding, and organ and tissue donation (United States Library of Medicine, 2019).

Durable Power of Attorney is a legal document; it identifies the individual as a principal and the surrogate decision-maker as attorney-in-fact. Items included in a Durable Power of Attorney differ from a living will in that the attorney-in-fact is authorized to handle financial and legal affairs. At the same time, if the principal cannot manage these affairs (Pozgar, 2020).A living will is utilized when the individual will be at imminent risk of death. The Durable Power of Attorney does not have the same application as it may be used even when imminent risk of death does not apply. Healthcare decision may be included in a Durable Power of Attorney document but is not required (Pozgar, 2020).

5.What is the purpose of an ethics committee? Describe a situation in the hospital setting where an ethics committee may play an important role.

Pozgar (2020) describes the ethics committee's purpose is to "facilitate discussion and consultation on ethical issues arising in the patient care setting." This advisory body's goal is to improve patient care and outcomes. The committee evaluates both the rights of patients and the delivery of care (Pozgar, 2020). Numerous ethical and legal issues present in hospital settings. One situation that would involve an ethics board in a hospital setting is life-support cases in which the patient family and physician disagree about withdrawing life support. These situations not only frequently appear in a hospital setting; many times, these cases are portrayed in the media and battled in the courtroom. The hospital ethics board is essential in navigating ethical issues in a hospital setting.

6.From your reading, what case or scenario did you find the most interesting? Describe why you found it interesting.

The case study, Spousal Rights in Decision Making, is impressive (Pozgar, 2020). It reaffirms the importance to establish advance directives to remove the guesswork on whether a patient would consent to a particular medical treatment. In this case, if the patient had proactively drafted advance directives, the issue may not have required legal action.

7.Find a current news article or court case (last 3 years) that discusses a right to die case or scenario. Give a brief overview of the case facts, issues to consider, and why you found it interesting.

On January 3, 2020, a Texas appeals court ordered 11-month-old, Tinslee to remain on

life-support (Associated Press, 2020). The original court denied an injunction filed by the parents, allowing the hospital to withdraw life support (Associated Press, 2020). Tinslee has lived her life in the hospital since birth. Tinslee was born prematurely and had a heart defect, chronic lung disease, and severe hypertension. Her life has been a struggle. In July, Tinslee went into respiratory distress and has been utilizing a ventilator since that time. Cook's Children's Medical Center in Fort Worth is scheduled to withdraw life support on November 10 by invoking the 10-day rule.

"The law stipulates that if the hospital's ethics committee agrees with doctors, treatment can be withdrawn after 10 days if a new provider can't be found to take the patient" (Associated Press, 2019). The hospital reported that despite best efforts, another facility had not been located. Tinslee's physicians assert that she is, and pain and treatments are no longer a benefit.

This is a problematic case both for the family of Tinslee and the medical team treating her. Tinslee continues to be medically sedated and using a ventilator and, at this time, has shown no signs of improvement. It is an interesting case because it brings to the forefront who decides to withdraw life support treatment when the family and medical team disagree.

References

Associated Press (2020, January 4). Hospital ordered to keep 11-month-old in Texas on life

support, appeals court says. https://www.nbcnews.com/news/us-news/appeals-court-

grants-order-keep-texas-baby-life-support-n1110381

Pozgar, G. D. (2020). Legal and ethical issues for health professionals (5th ed.). Burlington,

MA: Jones & Bartlett Learning.

United States Library of Medicine (2019, August 20). Advance directives. Medline Plus August

https://medlineplus.gov/advancedirectives.html