Chapter 121 Legal And Ethical Issues In Termination Or Refusal Of Care Continued From Previous Page Ar Each Case The 1 (53.49 KiB) Viewed 41 times
Chapter 121 Legal And Ethical Issues In Termination Or Refusal Of Care Continued From Previous Page Ar Each Case The 2 (40.1 KiB) Viewed 41 times
Chapter 121 Legal and Ethical issues in Termination or Refusal of Care (continued from previous page) Ar each case, the decision of the court is also provided. The goal activity is to determine whether the court's decision in each case onable in light of the specific facts of the case. And the description of each case and record the details in Exhibit With regard to the patients for whom treatment was continued, in writing any ways in which those cases were factually distin- pable from the cases in which treatment was terminated. CASE 1: Cruzan v. Director, Missouri Department of Health de Nancy Beth Cruzan was injured in a car accident, she was in a persistent vegetative state and had virtually no chance of regaining her pritive function. However, she was not terminally ill and was breath on her own. Her parents asked hospital employees to terminate the Aficial nutrition and hydration, but they refused to do so without a court order. Cruzan had never executed an advance directive, and the only evidence of her desires was a somewhat casual statement to a tiend. Specifically, Cruzan had indicated that she would not want to continue living if she were ever in a severely impaired condition. Cruzan's parents sought an order from a Missouri state court to ter minate the artificial nutrition and hydration. The Missouri court refused to order the termination of treatment on the grounds that there was to clear and convincing evidence of the patient's desire to terminate amificial nutrition and hydration. As discussed in Chapter 2, this case became the subject of a famous decision by the U.S. Supreme Court. However, because of the limited role of the federal courts, the U.S. Supreme Court did not consider the broad question of whether Cruzan should be allowed to die. Rather, the U.S. Supreme Court merely deter- mined that the state law of Missouri, which required clear and convinc Ingevidence of the patient's intent, did not violate the U.S. Constitution. Therefore, the Missouri court was entitled to apply its requirement of dear and convincing evidence. CASE 2: Bouvia v. Superior Court of Los Angeles County Elizabeth Bouvia was a 28-year-old quadriplegic with cerebral palsy She was almost completely immobile and in continual pain. Her condi- llen was irreversible and although she needed medication for pain, she was mentally competent (continued
b Н many cases, the action under considera con se termination of the patient's food and water through the removal of a nasogastric (NG) tube or other mechanical device. Therefore, it is important to focus on the specific facts about each individual patient in evaluating these cases and in answering Activity 12.1. ACTIVITY 12.1: CASES ON TERMINATION OF TREATMENT The facts about several individual patients are set forth here. Each of these patients was the subject of a judicial decision by the court of a particular state. In some cases, the court permitted the withholding or withdrawal of treatment, which presumably resulted in the patient's death. However, in three of these cases, the court held that treatment should be continued, and therefore, the patient was not allowed to die. (continued)
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