Why is it so important that one put in writing their exact wishes to the nature of their death and how they envision it should be?

  1. Ms. B was told that she had a brain aneurysm.  She made an advance statement of wishes saying that she did not want surgery if the aneurysm burst.  However, shortly after she made this statement of wishes, the aneurysm burst and a team of surgeons took her to surgery believing that if not treated with surgery she would surely die.  The hospital (Hospital #1) backed the decision of the surgeons thinking if there was no intervention the hospital would be liable for her death. This all happened as the family were alerted to the emergency and were making travel arrangements as they were all from out-of-town.

    Unfortunately, the outcome of the surgery was that she became ventilator-dependent paralyzed from the neck down and needing 24-hour care.  Once the family was in the hospital, they held a family conference agreeing that Ms. B would not want to continue on in this state, and they petitioned the hospital to remove her from the ventilator. The hospital refused still believing the potential for legal ramifications.  The family was distraught; but eventually, with the guidance of a lawyer they retained, they were able to have her transferred to another facility (Hospital #2) that was willing to take her off the ventilator knowing that the chances of her making it were slim.  The felt that they were honoring her wishes along with her families’ wishes.
    A day later Ms. B was taken off the ventilator and she expired within the hour.  The family felt like they had done the right thing and they retained the lawyer to sue the initial hospital stating that they had not honored the wishes of their loved ones.  In the trial, the hospital claimed that there was not enough evidence that Ms. B wished to not be placed on machines as the family claimed, even though it was witnessed by a nurse that the anesthesiologist for the care engaged her in a conversation about this very topic before her aneurysm burst.  The hospital maintained that without documentation to that claim, they could not honor her wishes.

    In a surprising turn of events, the family filed suit in the Court of Appeals and won.  The appellate court agreed with the family stating that any conversation, whether it be personal or professional could be used to reach a conclusion about one’s desire about the nature of their own death.

    Instructions:

    1. Read the Ms. B’s case study above.
    2. Answer the following questions:
      1. Do you agree with the original court or the court of appeals?  Why?
      2. What kind of ethical theories was hospital #1 acting upon (beneficence, malfeasance, etc.)?
      3. What kind of ethical theories was hospital #2 acting upon (beneficence, malfeasance, etc.)?
      4. How did the family act in this ethical realm?
      5. Did you find that the result of this case was fair to Mrs. B and her family?
      6. Why is it so important that one put in writing their exact wishes to the nature of their death and how they envision it should be?
    3. Your paper should be:
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      • Use factual information from the textbook and/or appropriate articles and websites.
      • Cite your sources – type references according to the APA Style Guide.
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