Essay Instructions: Let's begin our study of this material by reviewing the Faculty Notes & Readings, which will prepare you to participate in the discussions:
• Advance Directives / Surrogate Decision Making
Read the Faculty Notes:
In these days of longer life, better health, and a seemingly endless supply of technological advancements, dying and death are not concepts that most of us talk about, let alone think about and plan for. In every state in the U.S., advance directives, such as a living will or a durable power of attorney for health care, are accepted as legally and morally binding documents. Yet, over the fifteen years that advance directives have been universally recognized as valid expressions of end of life treatment wishes, the percentage of individuals that have completed one as a plan for their dying and death has remained virtually unchanged at twenty to twenty-five percent of the U. S. population.
Furthermore, because historically the goal of medicine has been to cure, death is often equated with failure--something to be avoided at great cost and accepted only when all attempts at cure have been exhausted and determined to be futile. This idea of death as a last resort, further fuels society’s view of death as a burden to be avoided.
Because death, rather than being viewed as a natural transition in one’s life, is held in such disfavor by healthcare professionals and lay people alike, most people are denied the benefits and support of palliative and hospice care while they are actively dying. A healthcare provider must refer an individual to hospice care. Usually the provider is reluctant to do so for a variety of reasons, including reticence to predict that the individual being referred will die within six months (a criteria for hospice admission), the desire to avoid discussing dying and death with the patient (often guided by the assumption that to do so would deny the patient hope), or the reality of the patient’s and/or family’s unwillingness to acknowledge that the patient is experiencing a terminal illness.
Deprived of palliative and hospice care at the end of life, or at the very least care guided by palliative and hospice care principles, individuals often are burdened with a host of incapacitating symptoms, particularly unrelieved pain, that frequently transform death into an undignified and horrific experience. Given the reality of these devastating experiences at the end of one’s life, it comes as no surprise that physician-assisted suicide (“PAS”), as a means to securing a preferential death, has gained a legal foothold in the states of Oregon, Washington and Montana.
Now, read the following:
Textbook:
Tong, Ch. 11, pgs. 263-74, 281-83 ??" Tong, R. (2007). New perspectives in healthcare ethics. Upper Saddle River, NJ: Pearson Prentice Hall.
Articles:
A medical ethics assessment of the case of Terri Schiavo. Death Studies.
Can law help us out?
Annals of Internal Medicine.
What would Terri want? On the psychological challenges of surrogate decision making.
Substituted Judgment: The Limitations of
Autonomy in Surrogate Decision Making
Recommended though NOT Mandatory to assist with explanation of standards of decision making
• Sanford Kadish, Letting Patients Die: Legal and Moral Reflections, 80 Cal. Law Review p. 857
Court Cases:
• Cruzan v. Director, Missouri Dep’t of Health, 497 U.S. 261 (1990) Available through the LexisNexis Academic database on the virtual library. Sign into LexisNexis, click on “Easy Search” and enter citation # into citation field.
o Only required to read the majority opinion (ends on page 287).
MAY read any of the additional concurring or dissenting opinions for indication of where the other judges stood and what issues were deemed controversial or important; often these opinions are a good gauge of what societal and political views were
• Bouvia v. Superior Court, 179 Cal. App. 3d 1127 (Cal. App. 2d Dist. 1986) This is a state court case out of California, therefore, the law is binding in the state of California (though it is also the predominately recognized law elsewhere). Available through the LexisNexis Academic database on the virtual library. Sign into LexisNexis, click on “Easy Search” and enter citation # into citation field
o Read through page 1137, paying attention to the facts and the overarching principles of basic rights every individula has, then reading again at page 1142 (section entitiled“THE CLAIMED EXCEPTIONS TO THE PATIENT’S RIGHT TO CHOOSE ARE INAPPLICABLE”)
• Blouin ex. Rel. Estate of Pouliot v. Spitzer, 356 F.3d 348 (2d Cir. 2004)
Let's begin our study of this material by reviewing the Faculty Notes & Readings, which will prepare you to participate in the discussions:
• Advance Directives / Surrogate Decision Making
Read the Faculty Notes:
In these days of longer life, better health, and a seemingly endless supply of technological advancements, dying and death are not concepts that most of us talk about, let alone think about and plan for. In every state in the U.S., advance directives, such as a living will or a durable power of attorney for health care, are accepted as legally and morally binding documents. Yet, over the fifteen years that advance directives have been universally recognized as valid expressions of end of life treatment wishes, the percentage of individuals that have completed one as a plan for their dying and death has remained virtually unchanged at twenty to twenty-five percent of the U. S. population.
Furthermore, because historically the goal of medicine has been to cure, death is often equated with failure--something to be avoided at great cost and accepted only when all attempts at cure have been exhausted and determined to be futile. This idea of death as a last resort, further fuels society’s view of death as a burden to be avoided.
Because death, rather than being viewed as a natural transition in one’s life, is held in such disfavor by healthcare professionals and lay people alike, most people are denied the benefits and support of palliative and hospice care while they are actively dying. A healthcare provider must refer an individual to hospice care. Usually the provider is reluctant to do so for a variety of reasons, including reticence to predict that the individual being referred will die within six months (a criteria for hospice admission), the desire to avoid discussing dying and death with the patient (often guided by the assumption that to do so would deny the patient hope), or the reality of the patient’s and/or family’s unwillingness to acknowledge that the patient is experiencing a terminal illness.
Deprived of palliative and hospice care at the end of life, or at the very least care guided by palliative and hospice care principles, individuals often are burdened with a host of incapacitating symptoms, particularly unrelieved pain, that frequently transform death into an undignified and horrific experience. Given the reality of these devastating experiences at the end of one’s life, it comes as no surprise that physician-assisted suicide (“PAS”), as a means to securing a preferential death, has gained a legal foothold in the states of Oregon, Washington and Montana.
Now, read the following:
Textbook:
Tong, Ch. 11, pgs. 263-74, 281-83 ??" Tong, R. (2007). New perspectives in healthcare ethics. Upper Saddle River, NJ: Pearson Prentice Hall.
Articles:
A medical ethics assessment of the case of Terri Schiavo. Death Studies.
Can law help us out?
Annals of Internal Medicine.
What would Terri want? On the psychological challenges of surrogate decision making.
Substituted Judgment: The Limitations of
Autonomy in Surrogate Decision Making
Recommended though NOT Mandatory to assist with explanation of standards of decision making
• Sanford Kadish, Letting Patients Die: Legal and Moral Reflections, 80 Cal. Law Review p. 857
Court Cases:
• Cruzan v. Director, Missouri Dep’t of Health, 497 U.S. 261 (1990) Available through the LexisNexis Academic database on the virtual library. Sign into LexisNexis, click on “Easy Search” and enter citation # into citation field.
o Only required to read the majority opinion (ends on page 287).
MAY read any of the additional concurring or dissenting opinions for indication of where the other judges stood and what issues were deemed controversial or important; often these opinions are a good gauge of what societal and political views were
• Bouvia v. Superior Court, 179 Cal. App. 3d 1127 (Cal. App. 2d Dist. 1986) This is a state court case out of California, therefore, the law is binding in the state of California (though it is also the predominately recognized law elsewhere). Available through the LexisNexis Academic database on the virtual library. Sign into LexisNexis, click on “Easy Search” and enter citation # into citation field
o Read through page 1137, paying attention to the facts and the overarching principles of basic rights every individula has, then reading again at page 1142 (section entitiled“THE CLAIMED EXCEPTIONS TO THE PATIENT’S RIGHT TO CHOOSE ARE INAPPLICABLE”)
• Blouin ex. Rel. Estate of Pouliot v. Spitzer, 356 F.3d 348 (2d Cir. 2004)
Let's begin our study of this material by reviewing the Faculty Notes & Readings, which will prepare you to participate in the discussions:
• Advance Directives / Surrogate Decision Making
Read the Faculty Notes:
In these days of longer life, better health, and a seemingly endless supply of technological advancements, dying and death are not concepts that most of us talk about, let alone think about and plan for. In every state in the U.S., advance directives, such as a living will or a durable power of attorney for health care, are accepted as legally and morally binding documents. Yet, over the fifteen years that advance directives have been universally recognized as valid expressions of end of life treatment wishes, the percentage of individuals that have completed one as a plan for their dying and death has remained virtually unchanged at twenty to twenty-five percent of the U. S. population.
Furthermore, because historically the goal of medicine has been to cure, death is often equated with failure--something to be avoided at great cost and accepted only when all attempts at cure have been exhausted and determined to be futile. This idea of death as a last resort, further fuels society’s view of death as a burden to be avoided.
Because death, rather than being viewed as a natural transition in one’s life, is held in such disfavor by healthcare professionals and lay people alike, most people are denied the benefits and support of palliative and hospice care while they are actively dying. A healthcare provider must refer an individual to hospice care. Usually the provider is reluctant to do so for a variety of reasons, including reticence to predict that the individual being referred will die within six months (a criteria for hospice admission), the desire to avoid discussing dying and death with the patient (often guided by the assumption that to do so would deny the patient hope), or the reality of the patient’s and/or family’s unwillingness to acknowledge that the patient is experiencing a terminal illness.
Deprived of palliative and hospice care at the end of life, or at the very least care guided by palliative and hospice care principles, individuals often are burdened with a host of incapacitating symptoms, particularly unrelieved pain, that frequently transform death into an undignified and horrific experience. Given the reality of these devastating experiences at the end of one’s life, it comes as no surprise that physician-assisted suicide (“PAS”), as a means to securing a preferential death, has gained a legal foothold in the states of Oregon, Washington and Montana.
Now, read the following:
Textbook:
Tong, Ch. 11, pgs. 263-74, 281-83 ??" Tong, R. (2007). New perspectives in healthcare ethics. Upper Saddle River, NJ: Pearson Prentice Hall.
Articles:
A medical ethics assessment of the case of Terri Schiavo. Death Studies.
Can law help us out?
Annals of Internal Medicine.
What would Terri want? On the psychological challenges of surrogate decision making.
Substituted Judgment: The Limitations of
Autonomy in Surrogate Decision Making
Recommended though NOT Mandatory to assist with explanation of standards of decision making
• Sanford Kadish, Letting Patients Die: Legal and Moral Reflections, 80 Cal. Law Review p. 857
Court Cases:
• Cruzan v. Director, Missouri Dep’t of Health, 497 U.S. 261 (1990) Available through the LexisNexis Academic database on the virtual library. Sign into LexisNexis, click on “Easy Search” and enter citation # into citation field.
o Only required to read the majority opinion (ends on page 287).
MAY read any of the additional concurring or dissenting opinions for indication of where the other judges stood and what issues were deemed controversial or important; often these opinions are a good gauge of what societal and political views were
• Bouvia v. Superior Court, 179 Cal. App. 3d 1127 (Cal. App. 2d Dist. 1986) This is a state court case out of California, therefore, the law is binding in the state of California (though it is also the predominately recognized law elsewhere). Available through the LexisNexis Academic database on the virtual library. Sign into LexisNexis, click on “Easy Search” and enter citation # into citation field
o Read through page 1137, paying attention to the facts and the overarching principles of basic rights every individula has, then reading again at page 1142 (section entitiled“THE CLAIMED EXCEPTIONS TO THE PATIENT’S RIGHT TO CHOOSE ARE INAPPLICABLE”)
• Blouin ex. Rel. Estate of Pouliot v. Spitzer, 356 F.3d 348 (2d Cir. 2004)
Let's begin our study of this material by reviewing the Faculty Notes & Readings, which will prepare you to participate in the discussions:
• Advance Directives / Surrogate Decision Making
Read the Faculty Notes:
In these days of longer life, better health, and a seemingly endless supply of technological advancements, dying and death are not concepts that most of us talk about, let alone think about and plan for. In every state in the U.S., advance directives, such as a living will or a durable power of attorney for health care, are accepted as legally and morally binding documents. Yet, over the fifteen years that advance directives have been universally recognized as valid expressions of end of life treatment wishes, the percentage of individuals that have completed one as a plan for their dying and death has remained virtually unchanged at twenty to twenty-five percent of the U. S. population.
Furthermore, because historically the goal of medicine has been to cure, death is often equated with failure--something to be avoided at great cost and accepted only when all attempts at cure have been exhausted and determined to be futile. This idea of death as a last resort, further fuels society’s view of death as a burden to be avoided.
Because death, rather than being viewed as a natural transition in one’s life, is held in such disfavor by healthcare professionals and lay people alike, most people are denied the benefits and support of palliative and hospice care while they are actively dying. A healthcare provider must refer an individual to hospice care. Usually the provider is reluctant to do so for a variety of reasons, including reticence to predict that the individual being referred will die within six months (a criteria for hospice admission), the desire to avoid discussing dying and death with the patient (often guided by the assumption that to do so would deny the patient hope), or the reality of the patient’s and/or family’s unwillingness to acknowledge that the patient is experiencing a terminal illness.
Deprived of palliative and hospice care at the end of life, or at the very least care guided by palliative and hospice care principles, individuals often are burdened with a host of incapacitating symptoms, particularly unrelieved pain, that frequently transform death into an undignified and horrific experience. Given the reality of these devastating experiences at the end of one’s life, it comes as no surprise that physician-assisted suicide (“PAS”), as a means to securing a preferential death, has gained a legal foothold in the states of Oregon, Washington and Montana.
Now, read the following:
Textbook:
Tong, Ch. 11, pgs. 263-74, 281-83 ??" Tong, R. (2007). New perspectives in healthcare ethics. Upper Saddle River, NJ: Pearson Prentice Hall.
Articles:
A medical ethics assessment of the case of Terri Schiavo. Death Studies.
Can law help us out?
Annals of Internal Medicine.
What would Terri want? On the psychological challenges of surrogate decision making.
Substituted Judgment: The Limitations of
Autonomy in Surrogate Decision Making
Recommended though NOT Mandatory to assist with explanation of standards of decision making
• Sanford Kadish, Letting Patients Die: Legal and Moral Reflections, 80 Cal. Law Review p. 857
Court Cases:
• Cruzan v. Director, Missouri Dep’t of Health, 497 U.S. 261 (1990) Available through the LexisNexis Academic database on the virtual library. Sign into LexisNexis, click on “Easy Search” and enter citation # into citation field.
o Only required to read the majority opinion (ends on page 287).
MAY read any of the additional concurring or dissenting opinions for indication of where the other judges stood and what issues were deemed controversial or important; often these opinions are a good gauge of what societal and political views were
• Bouvia v. Superior Court, 179 Cal. App. 3d 1127 (Cal. App. 2d Dist. 1986) This is a state court case out of California, therefore, the law is binding in the state of California (though it is also the predominately recognized law elsewhere). Available through the LexisNexis Academic database on the virtual library. Sign into LexisNexis, click on “Easy Search” and enter citation # into citation field
o Read through page 1137, paying attention to the facts and the overarching principles of basic rights every individula has, then reading again at page 1142 (section entitiled“THE CLAIMED EXCEPTIONS TO THE PATIENT’S RIGHT TO CHOOSE ARE INAPPLICABLE”)
• Blouin ex. Rel. Estate of Pouliot v. Spitzer, 356 F.3d 348 (2d Cir. 2004)
Let's begin our study of this material by reviewing the Faculty Notes & Readings, which will prepare you to participate in the discussions:
• Advance Directives / Surrogate Decision Making
Read the Faculty Notes:
In these days of longer life, better health, and a seemingly endless supply of technological advancements, dying and death are not concepts that most of us talk about, let alone think about and plan for. In every state in the U.S., advance directives, such as a living will or a durable power of attorney for health care, are accepted as legally and morally binding documents. Yet, over the fifteen years that advance directives have been universally recognized as valid expressions of end of life treatment wishes, the percentage of individuals that have completed one as a plan for their dying and death has remained virtually unchanged at twenty to twenty-five percent of the U. S. population.
Furthermore, because historically the goal of medicine has been to cure, death is often equated with failure--something to be avoided at great cost and accepted only when all attempts at cure have been exhausted and determined to be futile. This idea of death as a last resort, further fuels society’s view of death as a burden to be avoided.
Because death, rather than being viewed as a natural transition in one’s life, is held in such disfavor by healthcare professionals and lay people alike, most people are denied the benefits and support of palliative and hospice care while they are actively dying. A healthcare provider must refer an individual to hospice care. Usually the provider is reluctant to do so for a variety of reasons, including reticence to predict that the individual being referred will die within six months (a criteria for hospice admission), the desire to avoid discussing dying and death with the patient (often guided by the assumption that to do so would deny the patient hope), or the reality of the patient’s and/or family’s unwillingness to acknowledge that the patient is experiencing a terminal illness.
Deprived of palliative and hospice care at the end of life, or at the very least care guided by palliative and hospice care principles, individuals often are burdened with a host of incapacitating symptoms, particularly unrelieved pain, that frequently transform death into an undignified and horrific experience. Given the reality of these devastating experiences at the end of one’s life, it comes as no surprise that physician-assisted suicide (“PAS”), as a means to securing a preferential death, has gained a legal foothold in the states of Oregon, Washington and Montana.
Now, read the following:
Textbook:
Tong, Ch. 11, pgs. 263-74, 281-83 ??" Tong, R. (2007). New perspectives in healthcare ethics. Upper Saddle River, NJ: Pearson Prentice Hall.
Articles:
A medical ethics assessment of the case of Terri Schiavo. Death Studies.
Can law help us out?
Annals of Internal Medicine.
What would Terri want? On the psychological challenges of surrogate decision making.
Substituted Judgment: The Limitations of
Autonomy in Surrogate Decision Making
Recommended though NOT Mandatory to assist with explanation of standards of decision making
• Sanford Kadish, Letting Patients Die: Legal and Moral Reflections, 80 Cal. Law Review p. 857
Court Cases:
• Cruzan v. Director, Missouri Dep’t of Health, 497 U.S. 261 (1990) Available through the LexisNexis Academic database on the virtual library. Sign into LexisNexis, click on “Easy Search” and enter citation # into citation field.
o Only required to read the majority opinion (ends on page 287).
MAY read any of the additional concurring or dissenting opinions for indication of where the other judges stood and what issues were deemed controversial or important; often these opinions are a good gauge of what societal and political views were
• Bouvia v. Superior Court, 179 Cal. App. 3d 1127 (Cal. App. 2d Dist. 1986) This is a state court case out of California, therefore, the law is binding in the state of California (though it is also the predominately recognized law elsewhere). Available through the LexisNexis Academic database on the virtual library. Sign into LexisNexis, click on “Easy Search” and enter citation # into citation field
o Read through page 1137, paying attention to the facts and the overarching principles of basic rights every individula has, then reading again at page 1142 (section entitiled“THE CLAIMED EXCEPTIONS TO THE PATIENT’S RIGHT TO CHOOSE ARE INAPPLICABLE”)
• Blouin ex. Rel. Estate of Pouliot v. Spitzer, 356 F.3d 348 (2d Cir. 2004)
Individual Case Analysis ??" Terri Schiavo
2. Instructions
If viewing this through the Assignment tool, click the title above to go to the Submissions area.
Be sure to submit your activity using the APA writing style in one WORD document and place it in the appropriate assignment dropbox. Outcome:
By the end of this activity, you will be able to identify and discuss important legal, historical, policy, and ethical issues surrounding a highly contested and debated topic, present persuasive conclusions in an objective manner by utilizing closed universe materials to support and defend your position of choice and analyze one patient’s story from multiple perspectives and disciplinary approaches.
________________________________________
Preparation
This assignment is designed as an opportunity to help you learn how to develop and write a thorough and effective case analysis.
For this assignment, your case analysis will be completed as an individual activity and will be graded as part of your Written Assignment Grade. The objective of your assignment is to develop and write a case analysis paper. The paper must be a minimum length of 2 pages and a maximum length of 4 pages, double-spaced.
________________________________________
Follow the steps below to complete this case analysis:
STEP 1 ??" Read the Terri Schiavo Case found in your Tong, 2007 textbook, pages 267 through 268, as well as the four articles indicated in the reading assignments (this first case analysis represents a closed universe whereupon all of the sources have been provided to you and you are not required to do any additional research while preparing your analysis).
STEP 2 ??" Re-read the case, and associated articles, carefully so that you become familiar with all of its significant aspects. Make notes while reading that identify the who, what, when, where, and how of the case.
STEP 3 ??" Determine the facts of the case versus the speculation of information. Which facts are verifiable? Which “facts” are results of individual perception or interpretation?
STEP 4 ??" Respond to the following prompts:
• Describe the historical perspective relating to the issue. This should include a brief history of the Schiavo case through the judicial system and legislature (feel free to supplement your discussion with principles ascertained from the cases assigned in this week’s reading too) and a brief discussion on an individual’s right to refuse medical care.
• Identify and describe the moral/ethical issues present in the case
• State and discuss your ethical position relative to the issue--what would you do!
• Defend your stated ethical position by using the theories you learned about in the first Module to validate your response.
• Explain how each of the significant parties (i.e. Terri, her husband, her parents, the medical staff, taxpayers, etc.) would be impacted by your ethical position. Discuss a party that would have supported your ethical position, and why, and another that would have condemned your ethical position, and why.
• Discuss the health policy considerations that are present in this case.
• Summarize your analysis and conclude by discussing what could have been done to avoid this ethical issue.
STEP 5 ??" Draft your case analysis by
• Integrating the responses you prepared to the above directives
• Preparing a title page, introduction, and conclusion for your analysis
• Correcting all grammar and spelling errors--you are expected to write in clear, concise, well-organized English
• Preparing a bibliography with all references (even though the references have already been provided to you, this will be good practice for your next case analysis and your independent reading paper)
3. Due Date
September 30, 2012
