100
/
Attempt Score 100
-
100 %
100
/
Overall Grade (Highest Attempt) 100
-
100 %
Question 1 points
This is a theoretical case taken from VHA Intensive Ethics Advisory
Committee Training, 1998, as presented by Arthur R. Derse MD, JD. An 87-
year-old woman widowed for six years, who is otherwise healthy, was
visiting another city and abruptly became ill. She was seen in the emergency
department of the local VA and admitted to the on-call physician. The on-
call physician (who has not previously seen her) made the diagnosis of
bowel obstruction arid made arrangements for a surgeon to evaluate her.
The surgeon recommended surgery and obtained her consent for surgery.
The surgeon expects an uneventful recovery. She is told that she will be on
a ventilator for a short time after surgery. The patient tells the surgeon that
is OK as long as it is for a short time. She tells the surgeon that she does not
want to be dependent upon machines. She was asked upon admission
whether she had an advance directive. She replied that she has a living will
and a power of attorney for health care which names her daughter (who
does not live in the area) as her health care agent. The patient undergoes
surgery, which is successful in treating the underlying problem and does not
show any malignant causes, but in the recovery room she has a
cardiopulmonary arrest and is resuscitated. She is transferred to the ICU in
the care of the on-call physician. The physician attempts to wean her
gradually from the ventilator, but this is unsuccessful. Three days later, she
has regained consciousness but is still intubated. Though she cannot speak
because of the ventilator, she is able to write and asks that the tube be
removed. The attending physician tells her that she is dependent upon the
, ventilator and the patient needs to remain on the ventilator until she can
breathe on her own. She writes that she understands that she may die, but
she does not want to be on machines. Her only children -- a daughter and
son -- - have arrived. She repeats her wish to them that she wants the tube
removed. She writes to her daughter that "I don't want to die, but we all
have to die sometime, and I don't want to have to live on a machine. I know
that whatever the outcome, God will take care of me." Her daughter tells
the physician that her mother is adamant that she be off of machines and
she respects her mother's wishes, even if she cannot breathe on her own.
She says this is consistent with her previously expressed wishes and her
religious beliefs. Her son tells the physician that he disagrees with his sister
-- since his mother does not have a terminal condition, he can not see why
she should not be forced to put up with the ventilator until she can be
weaned from it. He feels that she is being shortsighted, and she will be
thankful to have been kept on the ventilator when she is finally able to be
weaned. Describe the criteria for giving "legal" consent. Were all elements
met in this case? In other words, did the patient demonstrate decision-
making capacity? Explain. (Minimum of 1 page including in-text citations
and references in proper APA format)
Criteria for Legal Consent and Decision-Making Capacity
A patient must fulfill a number of established requirements for legal
permission in order for the decision to be both morally and legally sound.
Decision-making ability, voluntariness, sufficient information disclosure, and
the capability to express a choice are the four fundamental components of
valid consent (Beauchamp & Childress, 2019; Pozgar, 2023). It is possible to
ascertain whether the 87-year-old postoperative patient's request to quit
receiving ventilator support qualifies as a legally permissible refusal of
treatment by evaluating these factors.
Decision-Making Capacity
Decision-making capability is a clinical assessment, not a legal one, and the
patient must show that they are able to:
/
Attempt Score 100
-
100 %
100
/
Overall Grade (Highest Attempt) 100
-
100 %
Question 1 points
This is a theoretical case taken from VHA Intensive Ethics Advisory
Committee Training, 1998, as presented by Arthur R. Derse MD, JD. An 87-
year-old woman widowed for six years, who is otherwise healthy, was
visiting another city and abruptly became ill. She was seen in the emergency
department of the local VA and admitted to the on-call physician. The on-
call physician (who has not previously seen her) made the diagnosis of
bowel obstruction arid made arrangements for a surgeon to evaluate her.
The surgeon recommended surgery and obtained her consent for surgery.
The surgeon expects an uneventful recovery. She is told that she will be on
a ventilator for a short time after surgery. The patient tells the surgeon that
is OK as long as it is for a short time. She tells the surgeon that she does not
want to be dependent upon machines. She was asked upon admission
whether she had an advance directive. She replied that she has a living will
and a power of attorney for health care which names her daughter (who
does not live in the area) as her health care agent. The patient undergoes
surgery, which is successful in treating the underlying problem and does not
show any malignant causes, but in the recovery room she has a
cardiopulmonary arrest and is resuscitated. She is transferred to the ICU in
the care of the on-call physician. The physician attempts to wean her
gradually from the ventilator, but this is unsuccessful. Three days later, she
has regained consciousness but is still intubated. Though she cannot speak
because of the ventilator, she is able to write and asks that the tube be
removed. The attending physician tells her that she is dependent upon the
, ventilator and the patient needs to remain on the ventilator until she can
breathe on her own. She writes that she understands that she may die, but
she does not want to be on machines. Her only children -- a daughter and
son -- - have arrived. She repeats her wish to them that she wants the tube
removed. She writes to her daughter that "I don't want to die, but we all
have to die sometime, and I don't want to have to live on a machine. I know
that whatever the outcome, God will take care of me." Her daughter tells
the physician that her mother is adamant that she be off of machines and
she respects her mother's wishes, even if she cannot breathe on her own.
She says this is consistent with her previously expressed wishes and her
religious beliefs. Her son tells the physician that he disagrees with his sister
-- since his mother does not have a terminal condition, he can not see why
she should not be forced to put up with the ventilator until she can be
weaned from it. He feels that she is being shortsighted, and she will be
thankful to have been kept on the ventilator when she is finally able to be
weaned. Describe the criteria for giving "legal" consent. Were all elements
met in this case? In other words, did the patient demonstrate decision-
making capacity? Explain. (Minimum of 1 page including in-text citations
and references in proper APA format)
Criteria for Legal Consent and Decision-Making Capacity
A patient must fulfill a number of established requirements for legal
permission in order for the decision to be both morally and legally sound.
Decision-making ability, voluntariness, sufficient information disclosure, and
the capability to express a choice are the four fundamental components of
valid consent (Beauchamp & Childress, 2019; Pozgar, 2023). It is possible to
ascertain whether the 87-year-old postoperative patient's request to quit
receiving ventilator support qualifies as a legally permissible refusal of
treatment by evaluating these factors.
Decision-Making Capacity
Decision-making capability is a clinical assessment, not a legal one, and the
patient must show that they are able to:
