L‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍egal Background In Cruzan v. Director, Missouri Department

L‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍egal Background In Cruzan v. Director, Missouri Department of Health, 110 S. Ct. 2841 (1990) the U.S. Supreme Court upheld the Missouri Supreme Court’s decision that the guardians of a patient did not have authority to order the withdrawal of a life support system. The patient, Nancy Cruzan had been in a car accident. She was in a coma and had been kept alive for nearly five years through a life support system. Her parents, acting as guardians, sought court approval to discontinue the nutrition and hydration administered through a gastrostomy tube. However, the Supreme Court of Missouri denied permission on the theory that the informal statements made by Nancy did not provide clear and convincing evidence of Nancy’s intent under the circumstances. In affirming the lower court’s decision, the Supreme Court ruled that while a competent person has a constitutionally protected liberty to discontinue life-sustaining treatment, an incompetent person does not possess that same right. Missouri was not barred from requiring clear and convincing evidence of an incompetent patient’s prior directives before withdrawing life-sustaining treatment. Eventually, five months after the . Supreme Court’s decision, a probate judge ruled that clear and convincing evidence of Nancy’s intent was produced and the treatment was discontinued. In April 1992, Pennsylvania was one of the last states to enact a living will statute. Such state laws permit living individuals to document their wishes regarding the termination of their life in certain circumstances. A number of the statutes embody a strong state policy to preserve life and some statutes require clear and convincing evidence of what the incompetent patient would have decided if competent. The Pennsylvania law prohibits physicians from honoring the living will of a pregnant woman unless keeping the woman alive would not result in a live birth or would cause pain that could not be ameliorated by medication. The constitutionality of the statute has yet to be challenged. Social Policy and Ethical Considerations In the absence of a document executed by the incapacitated individual, it has been suggested that close family members, or attending physicians should be allowed to make the decision to withhold medical treatment. The value in preserving life and dignity in life, the role of the family, physician, and court in making life‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍ and death decisions are among the issues raised by the sad and disturbing facts presented. The potential of pregnancy illustrates that the abortion issue may be embedded in a case involving the right to die. As noted above, the Pennsylvania law would override Nancy’s directive to die, had she expressed such an intent. If Nancy’s infant were born with a severe defect, (. potentially from medication to alleviate Nancy’s pain) could an action be maintained for a wrongful birth by relatives? Pregnancy adds significant constitutional and ethical questions. If attending physicians are placed in a position of having to make life and death decisions, strong procedural guidance should be provided. The question raises the issue of how society should impose accountability for these difficult decisions. Ethically, a patient’s wealth or insurance status should not make any difference in treatment decisions, but in reality, it may. A family may be unwilling to take on the financial burden surely to be left behind or a hospital may be unwilling to embark on a long, expensive treatment, knowing there will be no payment and little or no chance of survival for the patient. In light of the information provided, if you were given the responsibility to make a choice for the patient in this condition, what legal precedence would you use to what legal precedence would you rely on to make your decision? Explain! what ethical theory would you use to make an ethical decision and how would you rationalize your ethical choice? Explain! Before formulating your response, please research your answers, using IHCC online library peer-review journals to support your answers review the grading rubric for this assignment to make sure you understand grading expectations See APA & WRITING GUIDE inside the course module Writing requires formatting in APA, including pages, fonts, citation, references, etc. In addition to your textbook, this paper requires minimum of two peer-reviewed sources for IHCC online library in APA format. Wikipedia, encyclopedia, Google scholar, “.edu” “.com”, and “.org” sources are not accepted and will negatively impact your grade refer to IHCC guide for where to start and IHCC guide for finding peer-review articles Must find articles using this source- .‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍net/inverhills/subjects/

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