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Clinical Ethics Issues and A Framework for Thinking Ethically

Case Scenario

A 72 year old woman was admitted to the Neurological Intensive Care Unit following a cerebral hemorrhage which left her with severe brain damage and ventilator dependent. One year before this event, the patient and her husband had drawn up “living wills” with an attorney. She was diagnosed by her treating physician as being in a permanent unconscious condition. The patient’s living will specified that the patient did not want ventilator support or other artificial life support in the event of a permanent unconscious condition or terminal condition.

The patient’s husband is her legal next of kin and the person with surrogate decision-making authority. When the living will was discussed with him, he insisted that the patient had not intended for the document to be used in a situation like the present one. Further discussion with him revealed that he understood that the patient would not be able to recover any meaningful brain function but he argued that the living will did not apply because her condition was not imminently terminal. He further indicated that he did not consider his wife to be in a permanent unconscious condition.  The immediate family members (the couple’s adult children) disagreed with their father’s refusal to withdraw life support.

The treatment team allowed a week to pass to allow the husband more time to be supported in his grief and to appreciate the gravity of his wife’s situation.  Nevertheless, at the end of this time, the husband was unwilling to authorize withdrawal of life support measures consistent with the patient’s wishes as expressed in her living will. End of scenario.

You paper should have 3 major sections. Each is numbered 1, 2 and 3. Questions to be discussed based on the facts above. You must weave into your discussion the relevant facts from above scenario to support your discussion in discussion areas 2 and 3 below. And for discussion area 3 you must weave into your discussion the ethics philosophy you pick for each issue from the article A Framework for Thinking Ethically.  -5% penalty in grading rubric if fail to use appropriate underlined headings in your paper. 

  1. Three Legal/Ethical Issues. Just list the three most important legal/ethics issues in this scenario that you will discuss. They must be three separate, different and distinct issues. Pay particular attention to the article I furnished with this assignment. No explanation needed, just state them 1, 2, 3.
  2. Discussion of Three Legal/Ethical Issues.  Discuss the three most important ethical/legal issues you listed above. Must use the relevant facts in the scenario to support your discussion of the legal/ethical issues.

Must use underlined headings below.  Headings will be:

           Legal/Ethical issue 1 [state the issue] then discussion

           Legal/Ethical issue 2 [state the issue] then discussion

           Legal/Ethical issue 3 [state the issue] then discussion

For each legal/ethical issue above discuss

a. Why each is a legal /ethical issue?

b. Discuss each issue in the context of the scenario facts and

c. Define the concepts you use

 


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