The Case of The Surrogate Decision-Maker

1. The hospital did not take into consideration the terms of the living will for the patient which had excluded ventilator or life support in the occurrence of her terminal or permanent unconscious state.
2. The hospital and the children did not consider the decision made by the husband regarding the patient who was in the actual sense the surrogate decision-maker.
3. The surrogate decision-maker (husband to the patient) did not follow the decision as outlined in the patient’s living will which meant he failed to take into perspective the welfare of the patient.

Discussion of the Three Legal Issues

Clinical ethics entails an approach which helps healthcare practitioners in locating, evaluating, and resolving the legal and ethical issues arising in practice (Jonsen, Siegler, & Winslade, 1982). In particular, the clinical medicine setting is effective when the practitioners prioritize the informed consent, patient rights, truth-telling, pain relief, end-of-life care, and confidentiality among other things.

1. The hospital did not take into consideration the terms of the living will for the patient which had excluded the ventilator support in the occurrence of a terminal or permanent unconscious state.A living will is a document which outlines the desire of an individual when it comes to their medical treatment in the event, they undergo a terminal illness or become incapacitated (Jonsen, Siegler, & Winslade, 1982). Concerning our case, the patient had made it vivid that in the case of her permanent incapacitation because of a terminal illness or unconsciousness, she would not be in need of life support neither did she want ventilator support. However, the hospital left this decision to the husband who was only a surrogate decision-maker.
2. The hospital and the children did not consider the decision made by the husband regarding the patient who was in the actual sense the surrogate decision-maker. Since the hospital physician has found out that the patient was not in a position to provide them with the informed consent given her permanent unconscious state, it was his duty to allow the husband become the surrogate decision-maker. For this matter, the children of the patient and the hospital would deem fit if they respected the stand of the surrogate decision-maker of keeping his wife on life support. Besides, this would increase the chances of the patient staying alive, and the husband was the only individual who had the legal capacity to pass the decision to the physicians give the state of his wife.
3. The surrogate decision-maker (husband to the patient) did not follow the decision as outlined in the patient’s living will which meant he failed to take into perspective the welfare of the patient.

In the patient’s will, it was evident that she did not want to be put on life or ventilator support in the case of terminal illness or permanent unconscious condition. On the other hand, the husband being the surrogate decision-maker ought to have maintained the stand initially held by her wife as stated in her life will. However, he stated that the wife did not make the use of the document bearing the life will mandatory in such a situation like the one she was in at the time. He knew the impact that the illness had on the patient but thought that she would have recovered but without the required brain function. Hence, he thought it was imperative not to consider her welfare and deny her the life support services offered by the hospital. Important to note is that the husband as a surrogate decision-maker preferred to ignore the welfare of the patient as he feared to lose her.

How to Deal with the Issues

1. The hospital did not take into consideration the terms of the living will for the patient which had excluded ventilator or life support in the occurrence of her terminal or permanent unconscious state. The patient was entitled to make her own decision on what was to transpire in the event of permanent unconsciousness, and this was when she was well. For this matter, putting this into writing was through the living will. She made it clear that provision of artificial life support and ventilator services was not in any way her intention in the case of a terminal or permanent unconscious condition. The Rights approach as stated in the Ethical decision-making requires physicians to respect the rights of the patient (Ferrell, & Gresham, 1985). In our case, the patient did not want to be put on the ventilator or artificial life support as per the conditions in her living will. Thus, in a move to preserve the human dignity, people should be in a position to choose what they would like to do with their lives. The ethical actions work to protect the rights of the individuals affected by unexpected conditions. They state that all human beings given their abilities can decide how their treatment occurs as an end but not as a means to other ends. Hence, the physicians ought not to place the patient on the artificial life support.
2. The hospital did not take into consideration the terms of the living will for the patient which had excluded ventilator or life support in the occurrence of her terminal or permanent unconscious state. The surrogate decision-maker (husband of the patient) choose not to withdraw the life support of her wife which was against her living will. He was of the stand that if his wife had the capacity, she would settle on the same decision as his. Moreover, he claimed that the living will would only apply in other instances but not at that moment. The Common Good approach comes out clear when it comes to interlocking relationships and should be bound by ethical reasoning (Ferrell, & Gresham, 1985). However, there should be compassion in such an instance where the physician considers the vulnerability that comes with a given ruling. Hence, as a physician, I would hesitate to withdraw the artificial life support.
3. The surrogate decision-maker (husband to the patient) did not follow the decision as outlined in the patient’s living will which meant he failed to take into perspective the welfare of the patient.

The surrogate decision-maker who was the husband failed to comply to the ideal virtues of human beings by deciding to put her on life support. Moreover, he knew well that the wife would not recover with her normal mental ability. The Virtue approach states that the ethical actions should align themselves with the requirements of the ideal virtues (Jonsen, Siegler, & Winslade, 1982). Therefore, as an ethical physician, the patient was not supposed to be on life support. The main rationale behind this is because despite having the patient on life support, it was not adding to anything.

References

Jonsen, A. R., Siegler, M., & Winslade, W. J. (1982). Clinical ethics: a practical approach to ethical decisions in clinical medicine

Ferrell, O. C., & Gresham, L. G. (1985). A contingency framework for understanding ethical decision making in marketing. The Journal of Marketing, 87-96.